• Open Access

Risk Factors for Equine Postoperative Ileus and Effectiveness of Prophylactic Lidocaine

Authors


  • Performed at Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium. Results were presented at the BEVA Congress, Liverpool, September 2008.

Corresponding author: Sara Torfs, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; e-mail: sara.torfs@ugent.be

Abstract

Background: Postoperative ileus (POI) is a frequent and often fatal complication of colic surgery. Reliably effective treatments are not available.

Objectives: To determine risk factors and protective factors associated with POI, and to assess the effect of lidocaine IV on short-term survival.

Animals: One hundred and twenty-six horses that underwent small intestinal colic surgery and that survived for at least 24 hours postoperatively.

Methods: Retrospective cross-sectional study. The association of 31 pre-, intra-, and postoperative variables with POI and the association of lidocaine treatment with short-term survival were investigated. Associations were evaluated with univariable logistic regression models, followed by multivariable analysis.

Results: Significant associations of high heart rate (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.03–1.08), the presence of more than 8 L of reflux at admission (OR = 3.02, 95% CI 1.13–8.02) and the performance of a small intestinal resection (OR = 2.46, 95% CI 1.15–5.27) with an increased probability of POI were demonstrated. Prophylactic lidocaine treatment was significantly associated with a reduced incidence of POI (OR = 0.25, 95% CI 0.11–0.56). Lidocaine treatment was also significantly associated with enhanced short-term survival (OR = 0.30, 95% CI 0.09–0.98).

Conclusions and Clinical Importance: The variables associated with an increased risk of POI can be useful in identifying horses at risk of POI and in providing a more accurate prognosis. The results are supportive for lidocaine IV as an effective prokinetic treatment after small intestinal colic surgery.

Ancillary