Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?
Authors: Salem Shebl E, Proudman Chris J, Archer Debra C
Journal: BMC veterinary research
Summary
Postoperative ileus and intestinal ischaemia-reperfusion injury represent major complications following small intestinal surgery in horses, and intravenous lidocaine has become routine perioperative practice to mitigate these problems; however, evidence supporting its efficacy at a population level remained limited. Using prospective data collected from 2004–2006 and 2012–2014, Shebl and colleagues compared survival outcomes, postoperative reflux volume, and reflux duration in horses undergoing small intestinal surgery at a UK referral hospital, stratified by whether they received systemic lidocaine treatment. The researchers employed Kaplan-Meier survival analysis and multivariable Cox proportional hazards modelling to account for confounding pre- and intraoperative risk factors. Their analysis revealed that lidocaine administration did not significantly improve survival rates or reduce the prevalence, volume, or duration of postoperative nasogastric reflux—findings that challenge the widespread assumption that this treatment fundamentally alters outcomes in this population. For equine surgeons and anaesthetists, this suggests that whilst lidocaine may remain part of perioperative protocols for its other anti-inflammatory properties, practitioners should not rely upon it as a standalone preventive strategy for postoperative ileus, and management decisions should instead be informed by individual case assessment and proven ancillary interventions.
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Practical Takeaways
- •This study directly assesses the real-world clinical benefit of perioperative lidocaine in post-surgical small intestinal colic cases—results can help inform whether routine lidocaine use is justified in your practice
- •Large-population cohort data from a referral hospital provides relevant evidence for predicting outcomes and managing similar cases in your own facility
Key Findings
- •Study evaluated whether intravenous lidocaine reduced postoperative reflux prevalence, volume, and duration in horses undergoing small intestinal surgery
- •Data collected from two prospective studies (2004-2006 and 2012-2014) at a UK equine referral hospital
- •Kaplan-Meier survival analysis and multivariable Cox proportional hazards modeling were used to assess outcomes between lidocaine-treated and control groups