PubMed · 1048855
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J N Kerley. 1976. A case study: pacemaker implants with general anesthesia.. https://pubmed.ncbi.nlm.nih.gov/1048855/
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Anesthesia and surgery in a Quarter Horse affected with hyperkalemic periodic paralysis resulted in euthanasia after 7 days of postoperative recumbency. Initial recovery was uneventful after extensive sinus surgery, but within 2 hours, the horse had severe muscle weakness. Plasma electrolyte concentrations were within the normal range during the period of recumbency. There was no clinical or laboratory evidence of severe muscle damage. Despite treatment with acetazolamide, isoproterenol, and intensive nursing, the horse was unable to stand for more than a few seconds and developed severe decubital ulcers. Ultrastructural examination revealed nemaline rods and swollen mitochondria in disrupted myofibers.
Postoperative cerebral dysfunction is usually assumed to be a consequence of anaesthesia. Temporary postoperative confusion is quite common. This review points out that the anaesthetic technique is clinically relevant for mental dysfunction only in the few hours immediately following operation. Of primary importance are the preoperative state of the patient, the drugs used in the perioperative period, the type and duration of the operation, the technique of postoperative analgesia and sedation and the postoperative clinical course of the patient. Cerebral infarction is a very severe but rather rare complication which occurs mainly after the operation. The incidence of perioperative cerebral infarction is about 1% in 65-year-old patients and increases with higher age. An asymptomatic preoperative carotid bruit is not a risk factor; therefore, invasive investigations are not warranted. The most frequent cause for cerebral insults are emboli. Intraoperative hypotensive periods are very rarely responsible for cerebral insults. Peripheral and central nervous lesions due to positioning of the patient for the operation occur not frequently and are certainly an avoidable neurologic complication. Hypoxic cerebral damages are usually the consequence of anaesthetic mismanagement. Today they are very rare, due to modern monitoring techniques.