Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis.
Authors: Louro Luís F, Milner Peter I, Bardell David
Journal: Equine veterinary journal
Summary
# Editorial Summary When horses undergo general anaesthesia for arthroscopic or tenoscopic treatment of septic joints or tendon sheaths in the hindlimbs, recovery quality significantly impacts both immediate welfare and long-term outcomes. Louro, Milner and Bardell examined 170 general anaesthetics performed on 149 horses at a referral hospital over nine years, using multivariable logistic regression to identify perioperative factors influencing recovery quality. Horses receiving opioid epidural analgesia were three times more likely to achieve good quality recovery (odds ratio 3.0), whilst older animals, Cob-type breeds, and those requiring higher intraoperative doses of ketamine or thiopental showed significantly poorer recoveries. The findings suggest that incorporating opioid epidural analgesia into the perianaesthetic protocol for hindlimb synovial sepsis cases offers a practical strategy to improve recovery outcomes, particularly in older or heavier-set horses where anaesthetic requirements and age-related complications may otherwise compromise the post-operative period. However, the retrospective nature of this single-centre study means results are most directly applicable to similar facilities and patient populations; factors such as individual temperament and concurrent orthopaedic disease—both known to influence recovery—were not systematically recorded and warrant investigation in future prospective work.
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Practical Takeaways
- •Consider epidural opioid analgesia for horses undergoing hindlimb synovial sepsis surgery to improve recovery quality
- •Older horses and Cob breeds may need additional perioperative management strategies to optimize recovery outcomes
- •Minimize intraoperative dosages of ketamine and thiopental where possible to improve post-anaesthetic recovery quality
Key Findings
- •Opioid epidural analgesia was associated with good quality of recovery (OR 3.0, 95% CI 1.2–7.2, P = 0.02) in horses undergoing general anaesthesia for hindlimb synovial sepsis surgery
- •Cob breed was associated with poor quality of recovery (OR 0.16, P = 0.001)
- •Increasing age in years was associated with poor quality of recovery (OR 0.90, P = 0.004)
- •Higher intraoperative dosages of ketamine (OR 0.42, P = 0.04) and thiopental (OR 0.64, P = 0.01) were associated with poor quality of recovery