The effects of multiple anaesthetic episodes on equine recovery quality.
Authors: Platt J P, Simon B T, Coleman M, Martinez E A, Lepiz M A, Watts A E
Journal: Equine veterinary journal
Summary
# Editorial Summary: Repeated General Anaesthesia and Equine Recovery Quality Catastrophic fractures during recovery from general anaesthesia account for approximately 70% of anaesthetic deaths in horses, yet little is known about how multiple anaesthetic episodes affect recovery quality. Platt and colleagues conducted a controlled trial in which eight adult horses underwent six sevoflurane anaesthetics over 14 weeks for distal limb MRI, with recoveries video-recorded and scored by three blinded veterinary anaesthesiologists across nine parameters using visual analogue scales. Significantly, horses demonstrated progressive improvement in balance and coordination, reduced knuckling, and better overall recovery quality with successive anaesthetic events, whilst the duration of lateral recumbency increased; notably, total recovery time, number of standing attempts, and physiologic stability remained unchanged across episodes. These findings suggest that nervous system adaptation occurs with repeated anaesthesia, which may reassure owners and clinicians planning multiple procedures. However, the practical relevance requires cautious interpretation: the study involved minimal surgical stimulation and no pain, conditions markedly different from routine surgical colic cases or complex orthopaedic procedures where inflammation and physiologic stress significantly complicate recovery. The evidence supports counselling clients that anaesthetic experience may benefit recovery mechanics, but does not necessarily extrapolate to high-risk surgical scenarios where recovery complications remain a genuine concern.
Read the full abstract on PubMed
Practical Takeaways
- •Horses improve their recovery from anaesthesia with experience — inform owners that their horse's second and subsequent anaesthetics will likely involve better balance and coordination during wake-up
- •Repeated general anaesthesia (at least up to 6 episodes in 14 weeks) does not increase complications or morbidity in horses undergoing diagnostic procedures like MRI
- •Improved recovery quality with experience reduces the risk of catastrophic fractures during recovery, which account for 70% of anaesthetic fatalities in horses
Key Findings
- •GA recovery quality improved with repeated anaesthetic episodes, with significant improvements in balance/coordination and reduced knuckling
- •Duration of lateral recumbency increased with repeated GA events despite improved overall recovery quality
- •No differences in total recovery duration, number of attempts to stand, or most physiologic parameters across six GA events over 14 weeks
- •No change in anaesthetic morbidity with six repeated GA episodes, allowing clinicians to counsel clients that repeated GA is safe regarding recovery quality