Prevalence of Electrolyte Disturbances and Perianesthetic Death Risk Factors in 120 Horses Undergoing Colic Surgery.
Authors: Adami Chiara, Westwood-Hearn Holly, Bolt David M, Monticelli Paolo
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Electrolyte disturbances are common during colic surgery in horses, with hypocalcaemia affecting over half of the 120 surgical cases reviewed in this 2020 investigation, followed by hypokalaemia in 30% of patients—notably, salbutamol administration during anaesthesia significantly increased hypokalaemia risk. Perianesthetic mortality reached 38.3% across the cohort, with multivariate analysis identifying four critical risk factors: prolonged anaesthetic duration, greater body weight, pre-operative gastric reflux, and intraoperative tachycardia combined with acidosis. The findings underscore the importance of pre-operative optimisation to stabilise cardiovascular function and prevent the dangerous cascade of intraoperative tachycardia; clinicians should also exercise caution when administering salbutamol, as this commonly used bronchodilator may precipitate dangerous potassium depletion. For equine professionals involved in colic case management, these results suggest that careful fluid and electrolyte monitoring perioperatively—particularly in heavier horses or those presenting with gastric reflux—alongside minimisation of anaesthetic time where clinically feasible, may help mitigate the substantial mortality risk associated with surgical colic in this population.
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Practical Takeaways
- •Monitor and optimize hemodynamic status before anesthesia to minimize intraoperative tachycardia, a significant mortality risk factor
- •Exercise caution with salbutamol use in colic surgery as it may trigger hypokalemia; consider electrolyte supplementation if salbutamol is needed
- •Horses presenting with gastric reflux or those with greater body weight carry elevated perianesthetic mortality risk and may warrant additional perioperative monitoring and intervention
Key Findings
- •Hypocalcemia was the most common electrolyte disturbance at 52.5%, followed by hypokalemia at 30.0%
- •Hypokalemia was significantly associated with intraoperative salbutamol administration (P = 0.045)
- •Perianesthetic mortality rate was 38.3% (46 of 120 horses)
- •Anesthetic duration, body weight, gastric reflux, intraoperative tachycardia, and acidosis were significant risk factors for perianesthetic death