One of the most complicated parts of equine surgery is putting the horse under anesthesia and then bringing them out of anesthesia after the surgery is completed. A horse coming out of anesthesia may struggle and injure himself.
Additional complications can include side effects from the drugs used to anesthetize the horse, laryngeal collapse, nerve damage or muscle diseases, though a very low percentage of horses develop any of these. The majority of these complications are because of a sheer size of a horse. Equines were not made to be recumbent for long periods of time; when laid on their side or back, their mass can compress muscles and airways, reports The Horse.
Standing surgeries on horses that are sedated have shown good (if not better) results, without the added complications and cost of anesthesia. Though fully anesthetized surgeries are sometimes the only option, like for a colic case, many surgeries can be performed while the horse is standing, including ovary removal, simple fracture repair and castrations.
A standing surgery requires the horse to have medicated sedation, making him sleepy but not to the point of lying down; the horse is also given a local anesthesia at the surgery site to minimize pain. By keeping the horse standing, there is no risk of compression to muscles or airways.
Tieback surgeries are easier to perform when the horse is standing, as the structures in the throat are easier to identify and work with. Additionally, the horse doesn't have to be intubated, making the surgery easier to accomplish.
Tenotomies, where tendons are sliced for therapeutic reasons, are also more easily performed while the horse is standing as the tendon remains in its normal state of tension. Surgeries on sinuses and pelvic areas are also less complicated when the horse remains upright.
Finally, an added boon for standing surgeries is that the surgeon is able to immediately see if his repair functions correctly. The sedated horse can move and breathe, showing the surgeon immediately if any adjustments need to be made.
Read more at The Horse.
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