Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature.
Authors: Gozalo-Marcilla Miguel, Ringer Simone Katja
Journal: Animals : an open access journal from MDPI
Summary
# Recovery after General Anaesthesia in Adult Horses: A Structured Literature Review Recovery from general anaesthesia represents the highest-risk phase of the equine anaesthetic event, yet clinical guidance on optimising this critical period remains fragmented across the literature. Gozalo-Marcilla and Ringer conducted a comprehensive structured review of 444 peer-reviewed articles retrieved from PubMed and Web of Science, systematically categorising studies by evidence level to minimise the interpretative bias inherent in traditional narrative reviews. The research encompassed thirteen distinct topic areas—ranging from premedication and induction protocols through maintenance techniques (inhalant, TIVA, and PIVA), recovery pharmacology, recovery systems, and respiratory management—with 167 studies classified as level-1 evidence and a further 36 as level-2, providing a robust evidence base for clinical decision-making. By consolidating current knowledge on how different drug combinations, maintenance strategies, and recovery environments influence post-anaesthetic complications, this structured summary equips practitioners with a hierarchically organised resource for identifying which interventions carry the strongest scientific support. For farriers, veterinarians, and allied equine professionals involved in perioperative care, this work offers a credible framework for evaluating recovery protocols and selecting evidence-based approaches that reduce the morbidity and mortality associated with what remains the most hazardous phase of equine general anaesthesia.
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Practical Takeaways
- •Recovery protocols should be informed by Level 1 evidence studies; this review identifies which anaesthetic approaches have the strongest scientific support for improving safety outcomes
- •Clinicians can use this systematic categorization to identify evidence-based strategies for premedication, induction, and maintenance that are associated with smoother, safer recoveries
- •Given recovery's danger in horses, practitioners should prioritize techniques and drugs supported by high-level evidence rather than traditional practices lacking robust scientific validation
Key Findings
- •Structured literature review identified 444 articles on equine anaesthesia recovery classified into 13 categories with varying levels of evidence
- •Of reviewed articles, 167 were classified as Level of Evidence 1 (highest quality), with 90 at LoE 5 (lowest quality) and 8 unclassifiable
- •Recovery phase remains the most dangerous period of general anaesthesia in horses, highlighting critical need for evidence-based protocols
- •Literature encompasses premedication, induction, maintenance techniques (inhalant, TIVA, PIVA), and recovery management strategies with differential evidence support