Demographic, preoperative and anaesthesia-related risk factors for unsatisfactory recovery quality in horses undergoing emergency abdominal surgery.
Authors: I. Santiago-Llorente, Francisco Javier López-San Román, M. Villalba-Orero
Journal: Veterinary anaesthesia and analgesia
Summary
# Editorial Summary: Recovery Quality Following Emergency Colic Surgery This retrospective analysis of 313 horses undergoing emergency abdominal surgery examined which demographic, preoperative and anaesthetic factors predicted unsatisfactory recovery—defined as dangerous or poor quality awakenings—versus satisfactory recovery. Unsatisfactory recoveries occurred in 17.2% of cases, and multivariable statistical modelling identified three independent risk factors: requirement for dobutamine doses ≥1.5 μg kg⁻¹ minute⁻¹ (increasing unsatisfactory recovery odds by 6.6-fold), poor quality premedication (4.6-fold increase), and time to standing exceeding 70 minutes (2.6-fold increase). Notably, administration of romifidine during premedication was protective, and whilst intraoperative parameters such as elevated heart rate and low blood pressure correlated with poor recovery, these did not independently predict outcome when other factors were controlled for. For practitioners involved in perioperative management of colic cases, this work underscores that investment in robust premedication protocols and careful titration of inotropic support—rather than escalating to high-dose dobutamine—may substantially improve recovery safety and quality; prolonged time to standing itself warrants investigation as both a marker and potential mediator of recovery complications.
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Practical Takeaways
- •Optimize premedication protocols before colic surgery, as poor premedication quality is a strong modifiable risk factor for difficult recoveries
- •Monitor intraoperative cardiovascular stability carefully; high dobutamine requirements (≥1.5 μg/kg/min) signal increased risk of unsatisfactory recovery—consider reviewing anesthetic management if this dose is needed
- •Watch recovery time closely: if a horse takes >70 minutes to stand, expect higher risk of complications; ensure adequate post-operative monitoring and support
Key Findings
- •Unsatisfactory recovery quality (poor or dangerous) occurred in 17.2% of horses undergoing emergency colic surgery, with 82.8% achieving satisfactory recovery
- •Dobutamine dose ≥1.5 μg/kg/minute was the strongest predictor of unsatisfactory recovery (AOR=6.60)
- •Poor premedication quality significantly increased risk of unsatisfactory recovery (AOR=4.60)
- •Time to stand >70 minutes was associated with unsatisfactory recovery quality (AOR=2.59)