Successful management of ventricular bigeminy using lidocaine in a horse anaesthetised for emergency laparotomy
Authors: Dupont Julien, Caudron Isabelle, Loublier Clémence, Serteyn Didier, S. Charlotte
Journal: Veterinary Record Case Reports
Summary
# Editorial Summary A 13-year-old mare presented with colic one week postpartum requiring emergency laparotomy, during which she developed ventricular bigeminy whilst anaesthetised. Despite the arrhythmia, the mare maintained haemodynamic stability, allowing the surgical team to manage the cardiac disturbance pharmacologically rather than abandon the procedure. Intravenous lidocaine administration—initiated with two 1 mg/kg boluses followed by infusion at 1–2 mg/kg/h—successfully terminated the bigeminy, and the mare recovered uneventfully with full discharge 23 days postoperatively. Whilst cardiac arrhythmias in colic cases are commonly attributed to endotoxaemia, this case underscores the importance of conducting thorough postoperative cardiac evaluation to exclude other aetiologies and rule out underlying structural disease. The successful outcome demonstrates that ventricular bigeminy need not be a contraindication to necessary surgery in horses with adequate haemodynamic compensation, provided antiarrhythmic intervention is available and clinicians remain vigilant during the perioperative period.
Read the full abstract on the publisher's site
Practical Takeaways
- •If your anaesthetised colic horse develops ventricular bigeminy, lidocaine boluses (1 mg/kg IV) followed by infusion (1–2 mg/kg/h) can effectively restore normal rhythm without necessarily compromising recovery
- •Post-colic cardiac arrhythmias should prompt postoperative cardiac assessment rather than assuming they will resolve with endotoxaemia treatment alone
- •Haemodynamic stability during an arrhythmia episode does not guarantee safety—continue monitoring and be prepared to treat
Key Findings
- •Ventricular bigeminy developed intraoperatively during emergency laparotomy for colic in a postpartum mare without haemodynamic compromise
- •Lidocaine administered as two 1 mg/kg IV boluses followed by 1–2 mg/kg/h infusion successfully terminated the arrhythmia
- •Horse recovered uneventfully and was discharged 23 days postoperatively despite cardiac arrhythmia during anaesthesia
- •Cardiac arrhythmias in colic cases warrant postoperative cardiac evaluation rather than assuming endotoxaemia as sole cause