Anaesthetic-related deaths in horses halved in last 20 years, data shows

Strides are being made in horse anaesthesia, fresh findings show.

Anaesthetic-related mortality in horses has been cut by half in the past 20 years, fresh research shows.

Preliminary results of the fourth multicentre Confidential Enquiry of Perioperative Fatalities (CEPEF4) were published recently in journal Animals. CEPEF4 is the largest study globally on anaesthetic-related mortality in horses.

Three researchers from the veterinary faculties of Edinburgh, Zurich and the CEU Cardenal Herrera of Valencia universities, along with the two British authors who founded the study, reported on the first 6701 cases of anaesthesia and 1995 cases of sedation registered online in the study.

“This initial data reveals an encouraging and significant decrease in equestrian anaesthetic-related mortality, down from 1.9% to 1%, and to just 0.2% of animals in the cases of procedures conducted under sedation,” said veterinary anaesthesiology professor and co-author José Ignacio Redondo, with CEU Cardenal Herrera University, in Spain.

The latest CEPEF project is led by Miguel Gozalo-Marcilla, head of anaesthetics in the equine section of the Faculty of Veterinary Studies in Edinburgh.

Also taking part were Regula Bettschart-Wolfensberger, Anaesthesiology professor at the Faculty of Veterinary Studies of Zurich, José Ignacio-Redondo and Vetstream director Mark Johnston, lead author of the first three editions of the CEPEF along with globally renowned equestrian anaesthesia specialist, Dr Polly Taylor.

“There is still room for the anaesthesia-related mortality in this species to decrease further, down to the levels where the anaesthesia in small animals currently sits,” said Redondo. He leads the COMPLRED international study, which has shown that, after analysing over 61,000 cases in veterinarian centres worldwide, the anaesthetic-related mortality is at 0.75% in dogs and 0.68% in cats.

CEPEF4 has also cast a light on the progress of anaesthetic and sedation techniques applied to horses internationally, compared to previous editions of the study.

“The preliminary data already verifies that these new anaesthetic techniques and protocols are contributing to successfully decrease the anaesthetic-related mortality in horses,” Redondo said.

The internet has proved beneficial for the study. In just 11 months, during the Covid-19 pandemic, CEPEF4 has managed to gather almost 20,000 cases of equestrian anaesthesia from more than 70 veterinarian clinics in 20 countries and four continents, making it the largest study globally regarding the representativeness of the sample.

Countries such as Belgium, the United Kingdom, Ireland, France, the United States, Argentina, Australia, Switzerland and Spain provided the most data.

The submission form allows veterinarians from around the world to register the relevant clinical parameters of the horses they anaesthetize and the techniques used from their mobile phone, tablet or computer.

Another of the significant technological breakthroughs since the first editions of CEPEF, which began 20 years ago, is the addition of Big Data and machine learning techniques for the mass processing of registered data.

“The artificial intelligence used makes it possible to analyse data in a mass way and detect the most significant pieces of data among them, to identify the evolution of the risks of anaesthesia practically in real time, which allows us to continue improving the safety of anaesthesia in horses,” notes Redondo.

Researchers involved in the study have have met in Spain to plan the next stages of the research, with two main goals: To reach 50,000 anaesthesias performed and to conduct partial studies on several aspects of equestrian anaesthesia, not only those linked to mortality.

Gozalo-Marcilla, M.; Bettschart-Wolfensberger, R.; Johnston, M.; Taylor, P.M.; Redondo, J.I. Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results. Animals 2021, 11, 2549.

The study, published under a Creative Commons License, can be read here.

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