Pregabalin contributes to increased recovery time from isoflurane anaesthesia for magnetic resonance imaging in horses.
Authors: Blanton Abigail, Glass Kati G, Bayer Jeanette, Baetge Courtney, Watanabe Ryota, Sampson Sarah N, Lépiz Mauricio, Moreno Kara, Ida Keila K
Journal: Equine veterinary journal
Summary
# Pregabalin and Equine Recovery from MRI Anaesthesia Pregabalin, a gabapentinoid that reduces excitatory neurotransmitter release, is increasingly used for pre-operative anxiolysis in horses, yet its effects on recovery dynamics from isoflurane anaesthesia remain poorly characterised. Researchers reviewed anaesthetic records and blinded video assessments from 128 horses undergoing elective MRI of the limbs between July 2023 and August 2024—52 receiving pregabalin (median 3 doses of approximately 3.9 mg/kg) and 76 serving as controls—to evaluate whether pre-anaesthetic pregabalin administration altered recovery time or quality. Whilst pregabalin-treated horses required significantly fewer boluses of both butorphanol (4 vs 23 horses) and ketamine (8 vs 25 horses) during the procedure, they took longer to stand following recovery (median 60 minutes versus 53 minutes, p = 0.02); notably, recovery quality scores were excellent and equivalent between groups. Multivariable regression analysis identified age, pregabalin use, acepromazine, xylazine, and extubation timing as independent predictors of time to standing, collectively explaining 79% of variance. For practitioners, these findings suggest pregabalin may offer meaningful intra-operative benefits through reduced anaesthetic requirements without compromising recovery safety, though the trade-off of prolonged standing time warrants consideration in clinical decision-making—particularly important information for farriers and rehabilitation professionals managing post-operative convalescence.
Read the full abstract on PubMed
Practical Takeaways
- •Pregabalin effectively reduces intraoperative opioid and ketamine requirements for MRI procedures in horses, but plan for extended recovery times (approximately 7 minutes longer) when using it preoperatively
- •Recovery quality remains excellent with pregabalin use despite longer times to stand, making it a safe anxiolytic choice for elective MRI cases
- •Consider pregabalin dosing (3-5 doses of ~4 mg/kg) when managing anxious horses requiring MRI, as it may reduce the need for additional sedation during induction and maintenance
Key Findings
- •Pregabalin administration increased median time to stand by 7 minutes (60 min vs 53 min, p=0.02) compared to control group
- •Fewer pregabalin-treated horses required butorphanol for sedation (4/52 vs 23/76, p=0.008) and ketamine boluses during procedure (8/52 vs 25/76, p=0.03)
- •Recovery quality scores were excellent overall with no significant differences between pregabalin and control groups
- •Age, pregabalin, acepromazine, xylazine, time to first movement, and time to extubation were significant predictors of increased time to stand (R²=0.79)