Anaesthesia for analgesia of the standing surgery upper airway patient

Standing surgical procedures in horses are frequently an option but must be considered in reference to the surgical procedure to be performed, the surgeon’s skills and the ability to produce appropriate standing ‘anaesthesia’. The fact that these surgeries can be relatively fast, minimally invasive and low risk, puts more pressure on matching anaesthetic protocols so the anaesthesia does not become the biggest risk in the procedure.

Advantages of standing anaesthesia

Most drug combinations that permit the horse to remain standing would have less long-term consequences and would result in more rapid return to normal mentation and strength. The use of constant rate infusions (CRI) of sedatives and analgesics has greatly enhanced the control of the level of sedation and expanded the range of surgeries. Intermittent dosing of sedatives is an alternative; however, periods of profound sedation and inadequate sedation (peaks and troughs) make the quality of sedation inferior to the use of CRI. The combination of regional, epidural or local anaesthesia with systemic sedation and analgesia can result in profound sedation and pain relief. […]