International online survey to assess current practice in equine anaesthesia.
Authors: Wohlfender F D, Doherr M G, Driessen B, Hartnack S, Johnston G M, Bettschart-Wolfensberger R
Journal: Equine veterinary journal
Summary
# Editorial Summary: Current Practice in Equine Anaesthesia Twenty years after the last Confidential Enquiry into Perioperative Equine Fatalities (CEPEF), Wohlfender and colleagues surveyed 199 equine anaesthetists across 14 countries via online questionnaire to characterise contemporary anaesthetic practice and establish a baseline for CEPEF-4. Respondents worked across private hospitals (43%), private practices (36%) and university teaching hospitals (21%), with only 23% of institutions employing a diplomate in veterinary anaesthesia; despite this, monitoring practices were relatively sophisticated, with electrocardiography (80%), invasive arterial blood pressure measurement (70%) and pulse oximetry (60%) widely adopted, though capnography (55%) and blood gas analysis (47%) showed greater variation. Drug selection revealed consistent preferences—ketamine (96%), diazepam (83%), xylazine (68%), isoflurane (76%) and phenylbutazone (73%) predominated in standard protocols—though notable heterogeneity existed in adjunctive agents and perioperative drug combinations, with only 40% routinely utilising assisted recovery. The substantial variability in both monitoring sophistication and pharmacological protocols, combined with respondents' identification of preoperative patient status and anaesthetist training as critical outcome determinants, underscores the need for evidence-based standardisation in equine perioperative practice and makes a compelling case for the prospective CEPEF-4 study to establish which current practices truly optimise safety.
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Practical Takeaways
- •Current equine anaesthesia practices vary considerably internationally; consider benchmarking your monitoring and drug protocols against best practices with a trained anaesthetist
- •Basic monitoring (ECG, arterial BP, pulse oximetry) is standard in 60-80% of practices—ensure your facility maintains at least these modalities to improve patient safety
- •Anaesthetist training and preoperative assessment are the strongest predictors of successful outcomes; invest in continuing education and thorough preoperative evaluation of surgical candidates
Key Findings
- •199 veterinarians from 14 countries completed the survey, with 43% working in private hospitals, 36% in private practices, and 21% in university teaching hospitals
- •Wide variation in monitoring practices: electrocardiography (80%), invasive arterial blood pressure (70%), pulse oximetry (60%), and capnography (55%) were most commonly used
- •Ketamine (96%), diazepam (83%), xylazine (68%), and isoflurane (76%) were the most frequently used drugs in standard anaesthesia protocols
- •Only 23% of institutions had a diplomate of European or American colleges of veterinary anaesthesia on staff, and preoperative health status and anaesthetist training were identified as the main factors affecting anaesthesia outcomes