The Royal (Dick) School of Veterinary Studies
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CEPEF4 equine anaesthesia mortality study gathers data

Veterinary Anaesthesia and Analgesia service staff are leading the worldwide milestone CEPEF4 study, investigating equine mortality associated with general anaesthesia and standing sedation.

Anaesthetists and equine clinicians are being invited to participate in a study collecting data on horses undergoing general anaesthesia and standing sedation, to help lower the associated risks of general anaesthesia in horses.

Results from the multicentre study, known as Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4), will reveal current trends in equine anaesthetic practice and the outcome, in terms of disease and mortality. The study uses an online questionnaire.

Equine anaesthetic fatalities have been reported in previous studies as 10 times more likely than for other animals such as dogs and cats. The team behind the CEPEF4 initiative hopes to help reduce this risk of death by throwing light on practices associated with higher fatality.

Horse in surgery

Worldwide findings

Researchers behind the global project will update the findings of a similar initiative carried out almost two decades ago, known as CEPEF2.

Use of new technologies allows interactive data collection with virtually simultaneous analysis, allowing continuous updating of the information.

The CEPEF2 study compiled more than 40,000 cases from 62 centres all over the world, and identified a number of potential contributors to the high risk of anaesthetic-related mortality.

Researchers aim for the CEPEF4 study to amass a similar number of cases relating not only to general anaesthesia, but also those that can be performed on the standing horse.

The project is led by the R(D)SVS in collaboration with specialists from CEU Cardenal Herrera University, Spain and the University of Zürich, Switzerland. The team also is integrated with two authors of the previous CEPEF studies and is supported by the Association of Veterinary anaesthetists (AVA).

As of April 2021, 5 months into the study, more than 7,000 cases from more than 65 collaborating centres have been collected.


In the two decades since the last study of this type, there have been many improvements in anaesthesia practices and technology. We hope to generate a large dataset from different clinics around the world, to assess current trends and practices, and point to potential improvements in anaesthesia for horses and other equine animals.

Miguel Gozalo-MarcillaSenior Lecturer in Veterinary Anaesthesia and Analgesia, R(D)SVS

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