The use of lidocaine during anesthesiological support, in the surgical treatment of inversion of the large colon in horses

Abstract

Volvulus of the large colon is one of the most severe diseases of the gastrointestinal tract in horses. Without surgical treatment of this pathology, the mortality of horses reaches 100%. The success of surgical treatment depends on the complexity of the pathology, the time since the onset of the disease, the patient's condition before surgery. Operations in this pathology are impossible without general multimodal anesthesia. However, the anesthetic support of such patients is often accompanied by a large number of complications due to hemodynamic and metabolic disorders in the body, as a result of strangulation and stretching of the intestinal wall, abdominal compartment syndrome, as well as the impossibility of full stabilization of the patient's condition due to the need to perform the operation as soon as possible. This article discusses our experience of anesthetic management in the surgical treatment of horses diagnosed with volvulus of the large colon with and without lidocaine, the effect of lidocaine on the patient's condition during general anesthesia, recovery from anesthesia, and the occurrence of postoperative complications. The material for the article was data from twelve patients who underwent surgery for the elimination of volvulus of the large colon at the Forside Veterinary Clinic in the period 2021-2023. During the analysis of the data obtained, it was revealed that with the inclusion of infusion at a constant rate of lidocaine at a dosage of 2 mg/kg per hour in the protocol of multimodal anesthesia, the concentration of isoflurane decreased by an average of 1%, and the use of tiletamine-zolazepam became irrelevant. This made it possible to reduce the time of recovery from anesthesia and recovery of patients in the soft box, as well as the number of postoperative complications associated with general anesthesia, such as paralytic ileus and myopathy, even in patients with severe hemodynamic disturbances in the preoperative period. A lethal outcome was recorded in two out of six operated horses, in the anesthetic protocol of which lidocaine was not used. In patients with the use of lidocaine in the anesthesia protocol, a lethal outcome was recorded in one case out of six. Thus, after the inclusion of constant-rate infusion of lidocaine into the anesthesia protocol, the mortality rate was halved, from 30 to 15%.