Preoperative Fasting Increases Post-Anesthetic Colic Risk in Horses

Researchers evaluated the influence of 12-hour preoperative fasting on post-anesthetic colic prevalence in horses.
Horse on the operating table under general anesthesia.
In this study, preoperative fasting was associated with increased risk of post-anesthetic colic. | Getty Images

Post-anesthetic colic is a complication in horses undergoing general anesthesia (GA). Various preoperative feeding strategies are used in equine practice, yet their impact on post-anesthetic colic remains unclear. This retrospective cohort study aimed to identify perioperative risk factors associated with post-anesthetic colic and evaluate the influence of 12-hour preoperative fasting on post-anesthetic colic prevalence and fecal output. 

Research on Post-Anesthetic Colic Risk

The researchers reviewed medical records of horses undergoing nonabdominal surgery under GA. They categorized horses into fasted and nonfasted groups based on their pre-anesthetic feeding regimen. Multivariable logistic regression was used to identify variables associated with post-anesthetic colic. The researchers analyzed differences in fecal output and water intake between groups using a two-tailed hypothesis test. 

The study included 620 cases. Fasting (odds ratio [OR] 2.7, 95% CI 1.4–5.5, p = 0.005), increased surgery duration (per minute) (OR 1.01, 95% CI 1.002–1.02, p = 0.017), and increasing age (OR 1.08, 95% CI 1.02–1.15, p = 0.012) were significantly associated with post-anesthetic colic. Nonfasted horses passed significantly more manure postoperatively. Median (IQR) manure production per hour was 0.44 (0.31–0.61) piles in nonfasted versus 0.38 (0.25–0.50) piles in fasted horses during the first 24 hours post-anesthesia (p < 0.001) and 0.53 (0.42–0.67) versus 0.50 (0.36–0.63) in the second 24 hours post-anesthesia (p = 0.04). Water intake 12 hours pre-anesthesia was also higher in nonfasted horses (1.02 [0.73–1.75] L/h) compared to fasted horses (0.88 [0.53–1.75] L/h; p < 0.001). 

Bottom Line  

Preoperative fasting was associated with increased risk of post-anesthetic colic and reduced fecal output in horses. These findings support reconsidering fasting practices in equine anesthesia. 

https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.70100

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