Orthopaedic surgery: Arthrosocopy

摘要

Specific perioperative considerations for arthroscopy in horses are mostly related to the specialised equipment used in this procedure. Preoperative measures for arthroscopy differ little from other orthopaedic procedures in horses. Feed is withheld for 12 h. Perioperative medications consist of 24 h antimicrobial coverage with penicillin (22,000 iu/kg bwt i.v. q.i.d.) and gentamicin (6.6 mg/kg bwt i.v. s.i.d.) and 3 days of phenylbutazone (4.4 mg/kg bwt i.v. once preoperatively and 2.2 mg/kg bwt i.v. s.i.d. post operatively). If the necessary technical support is available, anaesthesia time can be significantly reduced by dipping the horse's limb prior to induction of anaesthesia. For most arthroscopies, horses are positioned in dorsal recumbency according to the surgeon's preference. A good support team knows not only how to position the horse but also understands the idiosyncratic demands of the surgeon, thereby reducing the time the horse needs under general anaesthesia. One of the more important parts of positioning is ensuring that the surgical site does not require the surgical team to adopt an awkward fatiguing position throughout the procedure, as surgeon fatigue always compromises technique. The position of the television monitor relative to the limb being operated on and the surgeon's position is crucial and may vary between surgeons. The electrical units driving the light source, video camera, suction unit, fluid pump and motorised instruments must be within easy reach. This can be assured by using a customised arthroscopy 'tower' with sufficient shelf space for all of the above.