Surgery

Desflurane linked to speedier recoveries in equine surgery, but with lots of caveats

By Adam Marcus

The volatile anesthetic agent desflurane may cost more than alternatives, and it is being shunned worldwide for its climate-warming potential, but it does have an advantage in equine surgery—desflurane is associated with faster recovery from elective procedures versus isoflurane, potentially reducing the risk of injuries and other trauma during the postoperative period.

Poor recoveries can be catastrophic and fatal to horses, and dangerous for clinicians trying to contain frantic animals, explained Kate White, MA, VetMB, PhD, DECVAA, FRCVS, a professor of veterinary anesthesia and analgesia and deputy head of school at the University of Nottingham School of Veterinary Medicine and Science, in England.

A recent study found that the time to standing was shorter for horses that received desflurane than for those given isoflurane. The desflurane-exposed horses also had fewer futile attempts to stand. “It could be inferred from this that there would then be less likelihood of injury since the horse had fewer failed attempts,” Dr. White said.

In the prospective, randomized, blinded clinical trial, Dr. White and her colleagues compared the effects of the 2 volatile anesthetic agents in 101 healthy horses scheduled for elective surgery at a single equine hospital in the UK. Other than maintenance of anesthesia with the different gases, all animals received the same protocol during the procedures, which included arthroscopies, genital surgery, hindlimb neurectomy and fasciotomy, and other common operations.

The procedures were timed and recorded on video for review by 2 experienced clinicians, who ranked the quality of recovery on a 5-point scale, with 5 being “no struggling, stood up at first attempt as if fully conscious” and 1 being “very violent (‘wall of death’) self-inflicted injury, prolonged struggling or unable to stand 2 hours after the end of anesthesia.”

The 51 horses that received desflurane made fewer attempts to stand, on average, before succeeding versus the 48 given isoflurane (2 vs. 4; P=0.08), and they stood roughly 50% faster (30 vs. 41 minutes, on average; P=0.0001), according to the researchers.

Other parameters of recovery, including ratings by the 2 observers and hemodynamic measures, did not differ significantly between the 2 groups, they reported.

Although the trial involved healthy horses, Dr. White said the findings may be even more relevant to animals with serious comorbidities, such as colic, for whom “rapid recovery may be an advantage.” However, more research on that question is needed, she said.

Meanwhile, the study comes against the backdrop of a move away from desflurane in human surgery. The compound has the highest potential to exacerbate global warming of any volatile anesthetic agent—roughly 13 times that of isoflurane and up to a whopping 2,500 times that of carbon dioxide, pound for pound—although some researchers have questioned those estimates. As a result, the European Union imposed stiff restrictions on the use of desflurane, effective Jan. 1, 2026.

Dr. White called those concerns “valid,” but she noted emerging technologies may be able to blunt the climate hazards of desflurane and other volatile agents by sequestering them after exhalation. What’s more, she said, some US veterinarians who continue to use desflurane for equine surgeries say the animals are “back to normal” more quickly, presumably because of the reduced solubility of the agent. “This brings potential benefit in being able to travel from the clinic or return more rapidly to normal activities such as eating or moving around,” she said. MeV

FOR MORE INFORMATION
White K, Hird J, Taylor P. Comparing isoflurane and desflurane: A prospective randomised blinded clinical trial in horses undergoing elective surgery. Vet Rec. 2025;e1–e10.
https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.70225