摘要：

Summary The Confidential Enquiry into Perioperative Equine Fatalities (CEPEF-1) is an observational multi-institutional prospective study of recovery outcome at 7 days post operatively, as called for by Steffey (1991). Data from 6,255 general anaesthetics (February 91-March 93) were submitted confidentially by 62 clinics. The outcomes of 333 cases which were subjected to euthanasia and which were not classified 'alive' or 'died' at 7 days, were excluded from the analysis. The remaining 5922 cases were analysed to identify risk ratios (RR) between survivors and nonsurvivors for a variety of factors. These preliminary results indicate an overall death rate, for equine patients dying or being subjected to euthanasia within 7 days of a general anaesthetic because of perioperative complications, of 102/6255 (1.6%). This mortality rate decreased to 46/5220 (0.9%) when all colic surgery and delivery of foals under general anaesthesia were excluded. There was an increased risk for mares in the last trimester of pregnancy (RR=6.4). Patients undergoing emergency abdominal procedures (colic patients and pregnant mares undergoing controlled or caesarean section delivery of foals) under general anaesthesia were at increased risk (RR=12.9) compared to ear, nose and throat surgery. Within orthopaedic surgery, patients requiring internal fixation were at increased risk (RR=3.2) compared to those undergoing miscellaneous orthopaedic surgery. There was no difference in risk between breeds. Patients not placed in dorsal recumbency were at reduced risk (RR=0.3-0.5) compared to those which were in dorsal recumbency. Lack of a sedative premedication and use of xylazine were associated with a RR of 6.2 and 2.1 respectively, compared to patients given only detomidine for sedative premedication. However, 90% of all induction regimes were at similar risk, except inhalation with halothane (RR=4.8) and guaiphenesin and ketamine combination (RR=4.3) compared to guaiphenesin and thiopentone combination. There was a reduction in risk for surgeries carried out in the last quarter of the year (RR=0.3), compared to surgery carried out in the first three-quarters. Patients younger than 1-week-old (RR=20.6) and between 1-week and 1-month-old (RR=4.3) and patients older than 12 years old (RR=3.1) were at increased risk, compared to patients age 2–4 years. The likelihood of death increased as the duration of anaesthesia increased beyond 61 min, with the greatest being operations lasting longer than 241 min (RR=7.6). Surgery performed outside of 0900–1700 h had increased risk, worst between 1801–2000 h (RR=9.9), compared to surgeries carried out between 0801–1300 h.

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