Antimicrobial prophylaxis not indicated for horses undergoing general anesthesia for elective MRI
Background
Post-anesthetic fever is a known complication of general anesthesia, however, its incidence in horses undergoing elective magnetic resonance imaging (MRI) is unknown.
Objective
To determine the incidence of post-anesthetic fever in horses undergoing elective orthopedic MRI and determine whether prophylactic antimicrobial therapy would be associated with a reduction in the incidence of post-anesthetic fever. We hypothesized that prophylactic antimicrobials would be associated with a reduction in the incidence of post-anesthetic fever.
Study design
Retrospective cross-sectional study.
Methods
This retrospective study included 791 elective orthopedic MRIs in systemically healthy horses between June 2006 and March 2020 that recovered from general anesthesia and did not undergo surgery or intensive medical therapy soon after recovery. Potential factors associated with post-anesthetic fever were evaluated using multivariable logistic regression. Case signalment, travel time, preanesthetic hematology and fibrinogen abnormalities, use of prophylactic antimicrobials, peri-anesthetic nonsteroidal anti-inflammatories, anesthesia time and recovery time were all evaluated for association with post-anesthetic fever.
Results
Of 791 MRI cases, 44 (5.6%) developed a post-anesthetic fever. Horses that received prophylactic antimicrobials were [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.98-7.46; p ≤ 0.001] more likely to develop a post-anesthetic fever than those that did not receive antimicrobials. Young horses (1-4 years of age) were (OR 2.8, 95% CI 1.26-6.17; p = 0.01) more likely to develop fever compared with adult horses (≥5 years of age).
Main limitations
Limitations of this study pertain to retrospective analysis including non-randomized case selection and incomplete data records.
Conclusions
While fever may indicate infection, most early post-anesthetic fevers resolved before discharge from the hospital with no identified cause. The use of prophylactic antimicrobials to reduce the risk of post-anesthetic fever for elective MRI is not supported by this study.
Sloane Hoblick et al. "Antimicrobial prophylaxis is not indicated for horses undergoing general anaesthesia for elective orthopaedic MRI." Equine Veterinary Journal. 2 August 2023. https://doi.org/10.1111/evj.13978.
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