Lovak altatási szövődményei – az elmúlt évek eredményei - Irodalmi összefoglaló

Abstract

SUMMARY In this article the authors review the literature concerning mortality associated with general anaesthesia in horses and assess whether there is evidence for a reduction in mortality over the 20 years. There were a lot of developments over the past 20 years in the field of veterinary anaesthesia- drugs: new induction agents, isoflurane or sevoflurane instead of halothane, equipment, knowledge- but the surgical interventions became also longer and more complex.The anaesthesia-associated mortality rate in horses is much higher than in other companion animals. In healthy horses it is approximately 1% but can be as high as 7, 8% in emergency cases. There are a lot of circumstances that can influence the risk factor and outcome of GA: ASA status, age, body weight, type and length of surgery, position during anaesthesia, other underlying disease, equipment, drugs, knowledge and experience of the anaesthetist and whether or not it was performed as an after-hours emergency procedures. In this paper the authors demonstrate the most common causes of death and complications based on the literature of the past few years. Intraoperative cardiac arrest tended to occur in association with the application of halothane and the number of cases decreased after the widespread use of isoflu-rane and sevoflurane. Long bone fractures during induction and recovery can lead to instant death or euthanasia. Geriatric patients, older brood mares, horses after fracture repair act for risk group. Myopathies and neuropathies also can be fatal due to the size and basic nature of the equine patients. There are a lot of components- position, padding, hypoxemia, type and duration of surgery, size and weight of the horse, other muscle diseases which can contribute this condition but the hypotension during GA is the most important risk factor. Therefore arterial blood pressure measurement and intervention is particularly important. Peripheral neuropathies affect most commonly the radial, femoral and facial nerves. These are painful conditions with loss of function potentially increasing the likelihood of bone fractures. Post- anaesthesia respiratory obstruction (PARO) includes nasal mucosal congestion, dorsal displacement of the soft palate, nostril occlusion, laryngospasm, bilateral laryngeal paresis or paralysis. Post- anaesthetic colic, thrombophlebitis, pneumonia, ophthalmic problemsalso can occur.All patients need a customized protocol based on a variety of risk factors, medical issues and the habit of the animal.