Topic:Analgesia
Analgesia in horses involves the use of medications and techniques to alleviate pain caused by injury, surgery, or chronic conditions. Effective pain management is important for the welfare and recovery of equine patients, as unmanaged pain can lead to complications and prolonged healing. Common analgesic agents used in horses include non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and local anesthetics. These agents work through various mechanisms to reduce pain perception and improve comfort. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, application, and clinical outcomes of analgesic strategies in equine medicine.
Analgesic effects of butorphanol tartrate and phenylbutazone administered alone and in combination in young horses undergoing routine castration. To compare the analgesic efficacy of administration of butorphanol tartrate, phenylbutazone, or both drugs in combination in colts undergoing routine castration. Methods: Randomized controlled clinical trial. Methods: 36 client-owned colts. Methods: Horses received treatment with butorphanol alone (0.05 mg/kg [0.023 mg/lb], IM, prior to surgery and then q 4 h for 24 hours), phenylbutazone alone (4.4 mg/kg [2.0 mg/lb], IV, prior to surgery and then 2.2 mg/kg [1.0 mg/lb], PO, q 12 h for 3 days), or butorphanol and phenylbutazone at the aforementioned dosages (12 horses/group). For single-drug-tr...
Intravenous tramadol: effects, nociceptive properties, and pharmacokinetics in horses. To determine the optimal dose, serum concentrations and analgesic effects of intravenous (IV) tramadol in the horse. Two-phase blinded, randomized, prospective crossover trial. Seven horses (median age 22.5 years and mean weight 565 kg). Horses were treated every 20 minutes with incremental doses of tramadol HCl (0.1-1.6 mg kg(-1)) or with saline. Heart rate, respiratory rate, step frequency, head height, and sweating, trembling, borborygmus and head nodding scores were recorded before and up to 6 hours after treatment. In a second study, hoof withdrawal and skin twitch reflex latencies (HWRL ...
Analgesic effect of butorphanol in ponies following castration. In the UK butorphanol has a marketing authorisation for administration to horses for sedation in combination with detomidine, and at a higher dose (0.1 mg/kg bwt), for the alleviation of pain. There is only a limited number of clinical studies designed to examine the analgesic effects of butorphanol administration following surgery. Objective: To investigate the effect of premedication with butorphanol on post operative pain following castration under general anaesthesia in ponies. Objective: Ponies receiving butorphanol would experience less pain after castration than ponies that did not rece...
Scintigraphic assessment of the metacarpophalangeal and metatarsophalangeal joints of horses with joint pain. Our aims were to evaluate the pattern of radiopharmaceutical uptake in horses with lameness related to the metacarpophalangeal and/or metatarsophalangeal joint and compare the results with similar information from sound horses. It was hypothesized bthat there would be a difference in radiopharmaceutical uptake between the lame and contralateral limb in unilaterally lame horses and that there would be a difference between lame and sound horses. Nuclear scintigraphic images of 43 horses with forelimb lameness and 30 horses with hindlimb lameness were evaluated. In all horses lameness was improve...
Pharmacokinetics of the injectable formulation of methadone hydrochloride administered orally in horses. Methadone hydrochloride is a synthetic mu-opioid receptor agonist with potent analgesic properties. Oral methadone has been successfully used in human medicine and may overcome some limitations of other analgesics in equine species for producing analgesia with minimal adverse effects. However, there are no studies describing the pharmacokinetics (PK) of oral opioids in horses. The aim of this study was to describe the PK of orally administered methadone (0.1, 0.2 and 0.4 mg/kg) and physical effects in 12 healthy adult horses. Serum methadone concentrations were measured by gas chromatography/m...
Effect of firocoxib or flunixin meglumine on recovery of ischemic-injured equine jejunum. To determine whether treatment of horses with firocoxib affects recovery of ischemic-injured jejunum, while providing effective analgesia. Methods: 18 horses. Methods: Horses (n = 6 horses/group) received saline (0.9% NaCl) solution (1 mL/50 kg, IV), flunixin meglumine (1.1 mg/kg, IV, q 12 h), or firocoxib (0.09 mg/kg, IV, q 24 h) before 2 hours of jejunal ischemia. Horses were monitored via pain scores and received butorphanol for analgesia. After 18 hours, ischemic-injured and control mucosa were placed in Ussing chambers for measurement of transepithelial resistance and permeability to lipo...
Use of epidurally derived evoked potentials for quantification of caudal nociception in ponies. To determine whether epidurally derived evoked potentials (EPs) can be used to reliably assess nociception and antinociception in ponies. Methods: 7 ponies. Methods: EPs and electromyograms (EMGs) from the quadriceps femoris muscles were recorded simultaneously, following electrical stimulation applied to the distal portion of the hind limb. The effect of increasing stimulus intensity, conduction velocities of the stimulated nerves, effect of epidurally applied methadone, and effect of systemically administered propofol were evaluated. Results: In the EP and EMG waveforms, 2 distinct complexes...
Pharmacokinetics of detomidine and its metabolites following intravenous and intramuscular administration in horses. Detomidine is commonly used i.v. for sedation and analgesia in horses, but the pharmacokinetics and metabolism of this drug have not been well described. Objective: To describe the pharmacokinetics of detomidine and its metabolites, 3-hydroxy-detomidine (OH-detomidine) and detomidine 3-carboxylic acid (COOH-detomidine), after i.v. and i.m. administration of a single dose to horses. Methods: Eight horses were used in a balanced crossover design study. In Phase 1, 4 horses received a single dose of i.v. detomidine, administered 30 microg/kg bwt and 4 a single dose i.m. 30 microg/kg bwt. In Phase...
Diffusion of contrast medium after perineural injection of the palmar nerves: an in vivo and in vitro study. Proximal diffusion of local anaesthetic solution after perineural anaesthesia may lead to the desensitisation of structures other than those intended. However, there is no evidence-based study demonstrating the potential distribution and diffusion of local anaesthetic solution after perineural analgesia in the distal limb. Objective: To document the potential diffusion of local anaesthetic solution using a radiopaque contrast model and to evaluate the influence of walking compared with confinement in a stable after injection. Methods: Radiopaque contrast medium was injected subcutaneously over...
Comparison of the effects of the alpha-2 agonists detomidine, romifidine and xylazine on nociceptive withdrawal reflex and temporal summation in horses. To evaluate and compare the antinociceptive effects of the three alpha-2 agonists, detomidine, romifidine and xylazine at doses considered equipotent for sedation, using the nociceptive withdrawal reflex (NWR) and temporal summation model in standing horses. Methods: Prospective, blinded, randomized cross-over study. Methods: Ten healthy adult horses weighing 527-645 kg and aged 11-21 years old. Methods: Electrical stimulation was applied to the digital nerves to evoke NWR and temporal summation in the left thoracic limb and pelvic limb of each horse. Electromyographic reflex activity was reco...
In vitro evaluation of differences in phase 1 metabolism of ketamine and other analgesics among humans, horses, and dogs. To investigate cytochrome P450 (CYP) enzymes involved in metabolism of racemic and S-ketamine in various species and to evaluate metabolic interactions of other analgesics with ketamine. Methods: Human, equine, and canine liver microsomes. Methods: An analgesic was concurrently incubated with luminogenic substrates specific for CYP 3A4 or CYP 2C9 and liver microsomes. The luminescence signal was detected and compared with the signal for negative control samples. Ketamine and norketamine enantiomers were determined by use of capillary electrophoresis. Results: A concentration-dependent decrease...
Behavioural and cardiorespiratory effects of a constant rate infusion of medetomidine and morphine for sedation during standing laparoscopy in horses. Standing surgical procedures are performed commonly in horses under sedation. This approach minimises the morbidity/mortality risks associated with general anaesthesia. The use of a medetomidine and morphine combination has not been investigated in horses despite the usefulness of each drug individually. Objective: To determine the efficacy of a medetomidine and morphine combination to produce standing sedation with minimal cardiorespiratory changes and adequate analgesia for exploratory laparascopy in mature horses. Objective: The combination of medetomidine and morphine will induce reliable ...
Short-term anaesthesia with xylazine, diazepam/ketamine for castration in horses under field conditions: use of intravenous lidocaine. Lidocaine single boluses and/or constant rate infusions are commonly administered intraoperatively during inhalant anaesthesia to lower inhalant concentrations, promote or maintain gastrointestinal motility, and potentially supplement analgesia. The benefits of using lidocaine with injectable anaesthesia for field surgeries has not been fully explored to determine advantages and disadvantages of lidocaine as an anaesthetic and analgesic adjunct in these conditions and impact on recovery quality. Objective: To evaluate the use of systemic lidocaine with a standard field injectable anaesthetic p...
Effects of intraarticular ropivacaine and morphine on lipopolysaccharide-induced synovitis in horses. To compare the intraarticular (IA) analgesic effects of ropivacaine and morphine in horses with experimentally induced synovitis. Methods: Randomized, blinded cross-over design. Methods: Twelve healthy mixed breed horses between 8-15 years old. Methods: Synovitis was induced in the left radio-carpal joint with an injection of lipopolysaccharide (Escherichia coli 055:B5). Six hours later, the horses were treated with an IA injection of 40 mg of ropivacaine (ROPI), 40 mg of morphine (MOR), 20 mg of ropivacaine added to 20 mg of morphine in saline (RM) or 4 mL of saline (SAL), as control. Analges...
Effects of radial extracorporeal shock wave therapy on radiographic and scintigraphic outcomes in horses with palmar heel pain. To investigate the effects of radial extracorporeal shock wave therapy (RESWT) on radiographic and scintigraphic variables in horses with clinical pain referable to the palmar heel. Methods: Eight client-owner horses with palmar heel pain were treated with RESWT for a total of three treatments. Nuclear scintigraphy and radiography were repeated at the beginning and completion of the study. Scintigram region of interest (ROI) density ratios were calculated and compared between treated limbs, untreated limbs, and a population of comparison limbs from eight horses free of lameness. Radiographs we...
Effect of detomidine on visceral and somatic nociception and duodenal motility in conscious adult horses. To evaluate the effects of detomidine on visceral and somatic nociception, heart and respiratory rates, sedation, and duodenal motility and to correlate these effects with serum detomidine concentrations. Methods: Nonrandomized, experimental trial. Methods: Five adult horses, each with a permanent gastric cannula weighing 534 +/- 46 kg. Methods: Visceral nociception was evaluated by colorectal (CRD) and duodenal distension (DD). The duodenal balloon was used to assess motility. Somatic nociception was assessed via thermal threshold (TT). Nose-to-ground (NTG) height was used as a measure of sed...
A comparison of epidural buprenorphine plus detomidine with morphine plus detomidine in horses undergoing bilateral stifle arthroscopy. To compare the analgesic efficacy of buprenorphine plus detomidine with that of morphine plus detomidine when administered epidurally in horses undergoing bilateral stifle arthroscopy. Methods: Prospective, randomized, blinded clinical trial. Methods: Twelve healthy adult horses participating in an orthopedic research study. Group M (n = 6) received morphine (0.2 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally; group B (n = 6) received buprenorphine (0.005 mg kg(-1)) and detomidine (0.15 mg kg(-1)) epidurally. Methods: Horses received one of two epidural treatments following induction of...
Evaluation of tramadol and its main metabolites in horse plasma by high-performance liquid chromatography/fluorescence and liquid chromatography/electrospray ionization tandem mass spectrometry techniques. Tramadol is a centrally acting analgesic drug that has been used clinically for the last two decades to treat pain in humans. The clinical response of tramadol is strictly correlated to its metabolism, because of the different analgesic activity of its metabolites. O-Desmethyltramadol (M1), its major active metabolite, is 200 times more potent at the micro-receptor than the parent drug. In recent years tramadol has been widely introduced in veterinary medicine but its use has been questioned in some species. The aim of the present study was to develop a new sensible method to detect the whole ...
Anti-inflammatory and analgesic effects of intra-articular injection of triamcinolone acetonide, mepivacaine hydrochloride, or both on lipopolysaccharide-induced lameness in horses. To assess analgesia, inflammation, potency, and duration of action associated with intra-articular injection of triamcinolone acetonide (TA), mepivacaine hydrochloride, or both in metacarpophalangeal (MCP) joints of horses with experimentally induced acute synovitis. Methods: 18 horses. Methods: Both forelimbs of each horse were injected with lipopolysaccharide (LPS) 3 times. After the first LPS injection, 1 forelimb of each horse was treated with intra-articular injection of mepivacaine (80 mg; n=6), TA (9 mg; 6), or mepivacaine with TA (same doses of each; 6) 12 hours after the initial LPS i...
Evaluation of clinical examination for differential diagnosis of lameness by navicular apparatus or heel pain in horses. To evaluation of clinical examination for differential diagnosis of navicular region pain from other forms of palmar heel pain in the forelimb in horses the present study was undertaken. Thirty four horses with lameness referable to the palmar aspect of the hoof based on their response to the palmar digital nerves analgesia were divided into 2 groups based on their response to both distal interphalangeal joint and navicular bursa analgesia. Horses that were profoundly improved by both analgesic blocks (distal interphalangeal joint and navicular bursa) were considered to have navicular region p...
Development of a technique for continuous perineural blockade of the palmar nerves in the distal equine thoracic limb. To develop a technique for placing continuous peripheral nerve block (CPNB) catheters adjacent to palmar nerves in horses and to evaluate the effect of low-volume local anesthetic (LA) infusion on nociception in the distal equine thoracic limb. Methods: In vitro and in vivo laboratory investigation. STUDY MATERIAL AND ANIMALS: Forty-two thoracic limbs from 22 equine cadavers and five horses. Methods: Thoracic limb specimens were dissected to find landmarks for catheter insertion adjacent to medial and lateral palmar nerves. Based on the anatomy of the proximal metacarpus, a technique for placi...
Analgesia from a veterinary perspective. The last decade has seen continued progress in both the recognition and management of animal pain. This upsurge in the use of analgesics in animals is welcome, but the main areas of use continue to be the control of postoperative or post-trauma pain, and the management of musculoskeletal pain, in companion animals and horses. The management of pain associated with other conditions, such as soft-tissue inflammation or cancer, is still relatively neglected. Pain management in farm animals, and in animals used in biomedical research could also be improved further. Apart from providing some intere...
Short term analgesic effect of extracorporeal shock wave therapy in horses with proximal palmar metacarpal/plantar metatarsal pain. Extracorporeal shock wave therapy (ESWT) is an accepted form of treatment for chronic cases of proximal suspensory desmitis (PSD). Subjective evaluation of horses shortly after being treated with ESWT has led clinicians to comment on an immediate reduction in lameness. This study aimed to evaluate the analgesic effect of ESWT on 16 horses with PSD or PSD-like pain in a fore- or hindlimb. To objectively assess lameness, gait analysis was performed on an instrumented treadmill before and 6, 24, 48 and 72h after ESWT of the origin of the suspensory ligament and the results compared to the effects...
In vitro evaluation of a single injection technique for diagnostic analgesia of the proximal suspensory ligament of the equine pelvic limb. To examine the anatomic relationship of the deep branch of the lateral plantar nerve (DBLPN) with structures of the proximal metatarsal region, and to define the anatomic location of a solution injected using a single injection technique for diagnostic analgesia of the proximal suspensory ligament (PSL). Methods: Descriptive study. Methods: Cadaveric equine pelvic limbs (n=29). Methods: The proximal metatarsal region of both pelvic limbs (n=5 horses, 10 limbs) was dissected and measurements were made of anatomic structures relative to the head of the 4th metatarsal bone (HMT4). A single inject...
Effects of analgesia of the digital flexor tendon sheath on pain originating in the sole, distal interphalangeal joint or navicular bursa of horses. Specific analgesic techniques are required in diagnosis of lameness to isolate the exact origin of pain to the many structures of the foot that may be involved. Objective: To determine if analgesia of the digital flexor tendon sheath (DFTS) results in anaesthesia of other portions of the foot, such as the sole, distal interphalangeal joint (DIPJ), or navicular bursa (NB). Methods: Lameness caused by pain in the dorsal margin or heel region of the sole of the foot was induced in 18 horses by: using set-screws to create solar pressure (Trial 1: n = 5); or administering endotoxin intrasynovially ...
Development of a composite orthopaedic pain scale in horses. This study addresses development and validation of a composite multifactorial pain scale (CPS) in an experimental equine model of acute orthopaedic pain. Eighteen horses were allocated to control (sedation with/without epidural analgesia - mixture of morphine, ropivacaine, detomidine and ketamine) and experimental groups: amphotericin-B injection in the tarsocrural joint induced pain and analgesia was either i.v. phenylbutazone administered post-induction of synovitis, or pre-emptive epidural mixture, or a pre-emptive combination of the 2. Inter- and intra-observer reproducibility was good (0....
Effect of fentanyl on visceral and somatic nociception in conscious horses. Transdermal fentanyl is used clinically in horses based on pharmacokinetic data and antinociceptive effects documented in other species. Objective: Fentanyl IV administration increases both visceral and somatic nociceptive threshold in conscious horses. Methods: Six clinically normal horses, each fitted with a permanent gastric cannula. Methods: Visceral nociception was evaluated with 2 methods of threshold detection--olorectal distention and duodenal distention. Somatic nociception was assessed by measurement of thermal threshold. Fentanyl was administered as an increasing stepwise infusion f...
The use of alpha-2 agonists in the equine practice: comparison between three molecules. Alpha-2 agonists are synthetic drugs which cause sedation, analgesia and myorelaxation due to their interaction with alpha-2 adrenoreceptors, widely distributed throughout bodily systems. Because of these actions such drugs are generally used in veterinary practice: to tranquilize animals (pharmacologic restraint) for the safety of both veterinar-ians and cooperators. Such properties facilitate diagnostic examinations or minimally in-vasive and poorly painful surgical procedures, as well as limiting stress factors to the patients. The aim of this study is to find out the minor dosage able to m...
Meperidine prolongs lidocaine caudal epidural anaesthesia in the horse. The aim of the study was to evaluate and compare the effects of caudal epidural administration of meperidine (MP), lidocaine (LD), and a combination of the two (MPLD) in six mature saddle horses. Horses were randomly assigned to receive three treatments (MP 0.3 mg/kg; LD 0.2 mg/kg; and MPLD: MP 0.3 mg/kg and LD 0.2 mg/kg), with at least 1 week between treatments. Drugs were injected into the epidural space between the first and second coccygeal areas in conscious standing horses. Analgesia, ataxia, sedation, cardiovascular and respiratory effects, and rectal temperature were recorded at differ...