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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.
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...
Plasma concentration and local anesthetic activity of procaine hydrochloride following subcutaneous administration to horses. To determine the durations of the local anesthetic effect and plasma procaine concentrations associated with 5- and 10-mg doses of procaine hydrochloride (with or without 100 microg of epinephrine) administered SC over the lateral palmar digital nerves of horses. Methods: 6 healthy adult horses. Methods: The hoof withdrawal reflex latency (HWRL) period was determined by use of a focused heat lamp before and after administration of procaine with and without epinephrine. Blood samples were collected immediately before determination of each HWRL period to assess plasma concentrations of procaine ...
Multivariable analysis of factors influencing outcome of 2 treatment protocols in 128 cases of horses responding positively to intra-articular analgesia of the distal interphalangeal joint. There is limited knowledge available of factors influencing response to treatments of the DIP-joint in horses with lameness responding to diagnostic analgesia of the DIP-joint. For this reason a multivariable statistical analysis was performed. Objective: Horses with lameness reduced by > or = 75% 10 min after intra-articular analgesia of the DIP-joint, can be treated successfully by intra-articular medication of the joint. Multiple factors influence the response to treatment. Methods: The study was performed retrospectively based on clinical records of horses treated with either polysulpha...
Canadian veterinarians’ use of analgesics in cattle, pigs, and horses in 2004 and 2005. Anecdotal evidence suggests that many veterinarians may not use analgesics in livestock for routine surgical procedures or painful disease states. To investigate this, we conducted a national mail survey of a random sample of 1431 Canadian veterinarians (response rate, 50.1%). Questions primarily concerned veterinarians' analgesic usage for common surgeries and medical conditions in beef and dairy cattle, pigs, and horses, and attitudes toward pain management. More than 90% of veterinarians used analgesic drugs for equine surgeries, for cesarean section in sows and cows, and for bovine claw am...
Effects of buprenorphine on nociception and spontaneous locomotor activity in horses. To investigate spontaneous locomotor activity (SLA) and antinociceptive effects of buprenorphine in horses. Methods: 6 healthy adult horses. Methods: Horses received each of 3 treatments (10 mL of saline [0.9% NaCl] solution, 5 microg of buprenorphine/kg, or 10 microg of buprenorphine/kg). Treatments were administered IV. Order of treatments was randomized, and there was a 10-day interval between subsequent treatments. Spontaneous locomotor activity was investigated in a behavioral box by use of infrared photoelectric sensors connected to a computer, which detected movement of each horse. Anti...
Effects of butorphanol on the withdrawal reflex using threshold, suprathreshold and repeated subthreshold electrical stimuli in conscious horses. To assess the effects of a single intravenous dose of butorphanol (0.1 mg kg(-1)) on the nociceptive withdrawal reflex (NWR) using threshold, suprathreshold and repeated subthreshold electrical stimuli in conscious horses. Methods: 'Unblinded', prospective experimental study. Methods: Ten adult horses, five geldings and five mares, mean body mass 517 kg (range 487-569 kg). Methods: The NWR was elicited using single transcutaneous electrical stimulation of the palmar digital nerve. Repeated stimulations were applied to evoke temporal summation. Surface electromyography was performed to record a...
Comparison of intraoperative pain responses following intratesticular or mesorchial injection of lidocaine in standing horses undergoing laparoscopic cryptorchidectomy. To compare pain responses in stallions undergoing standing laparoscopic cryptorchidectomy following intratesticular or mesorchial infiltration of lidocaine. Methods: Clinical trial. Methods: 20 stallions with 1 or 2 undescended testes. Methods: Standing horses were administered a nonsteroidal anti-inflammatory drug and a caudal epidural injection of detomidine hydrochloride and underwent laparoscopic cryptorchidectomy. The undescended testis (1/horse) was grasped to determine the preoperative pain response (present vs absent) and assess severity of pain (by use of a visual analog scale [VAS])....
Pharmacodynamic effects and pharmacokinetic profile of a long-term continuous rate infusion of racemic ketamine in healthy conscious horses. Ketamine (KET) possesses analgesic and anti-inflammatory activity at sub-anesthetic doses, suggesting a benefit of long-term KET treatment in horses suffering from pain, inflammatory tissue injury and/or endotoxemia. However, data describing the pharmacodynamic effects and safety of constant rate infusion (CRI) of KET and its pharmacokinetic profile in nonpremedicated horses are missing. Therefore, we administered to six healthy horses a CRI of 1.5 mg/kg/h KET over 320 min following initial drug loading. Cardiopulmonary parameters, arterial blood gases, glucose, lactate, cortisol, insulin, non...
Pharmacokinetics of fentanyl delivered transdermally in healthy adult horses–variability among horses and its clinical implications. The safety and pharmacokinetics of fentanyl, delivered transdermally at a dosage of 60-67 microg/kg, were investigated in six healthy adult horses. Three transdermal fentanyl patches (Duragesic), each containing 10 mg of fentanyl citrate, were applied to the mid-dorsal thorax of each horse and left in place for 72 h. Plasma fentanyl concentrations were periodically measured throughout this period and for 12 h after patch removal. After an initial delay of approximately 2 h, the plasma fentanyl concentration rose rapidly in a fairly linear fashion, reaching a peak at around 12 h; thereafter, it...
High throughput screening of sub-ppb levels of basic drugs in equine plasma by liquid chromatography-tandem mass spectrometry. This paper describes a high throughput LC-MS-MS method for the screening of 75 basic drugs in equine plasma at sub-ppb levels. The test scope covers diversified classes of drugs including some alpha- and beta-blockers, alpha- and beta-agonists, antihypotensives, antihypertensives, analgesics, antiarrhythmics, antidepressants, antidiabetics, antipsychotics, antiulcers, anxiolytics, bronchodilators, CNS stimulants, decongestants, sedatives, tranquilizers and vasodilators. A plasma sample was first deproteinated by addition of trichloroacetic acid. Basic drugs were then extracted by solid-phase e...
Regional differences in transdermal penetration of fentanyl through equine skin. The rate and regional differences for the penetration of fentanyl through equine skin was investigated in vitro using a commercial transdermal therapeutic system (TTS) or 'patch'. Skin collected from the thorax, groin and leg (dorsal metacarpal) regions of five horses was placed in diffusion cells and a fentanyl TTS applied to each skin sample. Drug penetration through each skin sample over 48 h measured using high performance liquid chromatography (HPLC). Cumulative penetration (microg/cm2) was plotted against time (h) and used to regress the steady state flux (microg/cm2/h) of fentanyl throu...
Evidence of bias affecting the interpretation of the results of local anaesthetic nerve blocks when assessing lameness in horses. Eighteen observers were influenced to different extents in the grades of lameness they allocated to eight horses by whether they knew that a nerve block had been administered; on a scale from 0 to 10 the mean difference in grade allocated once the observer knew a horse had been nerve-blocked was increased by 0.4. The consistency of the assessments made by the individual observers was good, with a an average of 0.6 of a grade difference when grading the same horse on two occasions. The agreement between the assessments of four orthopaedic experts was reasonable (+/-1 grade), but significantly p...
Pharmacokinetics and clinical effects of a subanesthetic continuous rate infusion of ketamine in awake horses. To determine the pharmacokinetics and clinical effects of a subanesthetic, continuous rate infusion of ketamine administered to healthy awake horses. Methods: 8 adult horses. Methods: Ketamine hydrochloride was administered to 2 horses, in a pilot study, at rates ranging from 0.4 to 1.6 mg/kg/h for 6 hours to determine an appropriate dose that did not cause adverse effects. Ketamine was then administered to 6 horses for a total of 12 hours (3 horses at 0.4 mg/kg/h for 6 hours followed by 0.8 mg/kg/h for 6 hours and 3 horses at 0.8 mg/kg/h for 6 hours followed by 0.4 mg/kg/h for 6 hours). Conce...
Clonidine in horses: identification, detection, and clinical pharmacology. Clonidine is classified as a class 3 performance-enhancing agent by the Association of Racing Commissioners International and thus has the potential to influence the outcome of a race. In this study, the authors developed and validated a sensitive gas chromatograph and mass spectrometer method to determine the pharmacokinetic parameters of clonidine in equine plasma samples after IV administration of a single dose (0.025 mg/kg) of clonidine in horses. At this dose, clonidine produced rapid and profound sedation, which cold be quickly reversed with yohimbine. Clonidine was able to produce an an...
Analgesic effects of subarachnoidally administered hyperbaric opioids in horses. To evaluate the effects of subarachnoidally administered hyperbaric morphine, buprenorphine, and methadone on avoidance threshold to noxious electrical stimulation of the perineal, sacral, lumbar, and thoracic regions in horses. Methods: 6 healthy adult horses. Methods: Horses were assigned to receive subarachnoid administration of hyperbaric morphine (0.01 mg/kg), buprenorphine (0.001 mg/kg), methadone (0.01 mg/kg), or 10% dextrose solution in equal volumes (5 mL). Electrical stimulation was applied every 10 minutes for 60 minutes and every 30 minutes for 120 minutes after subarachnoid inject...
The effect of hyoscine on dobutamine requirement in spontaneously breathing horses anaesthetized with halothane. To determine whether hyoscine has a sparing effect on the volume of dobutamine required to maintain mean arterial pressure (MAP) at 70 mmHg in horses anaesthetized with halothane. Methods: Prospective, randomized, controlled clinical trial. Methods: Twenty adult horses weighing 507 +/- 97 kg (mean +/- SD), aged 10 +/- 5 years. Methods: Pre-anaesthetic medication in all horses was intramuscular (IM) acepromazine (40 mug kg(-1)) and intravenous (IV) detomidine (0.02 mg kg(-1)). Anaesthesia was induced with ketamine (2.2 mg kg(-1) IV) and diazepam (0.02 mg kg(-1) IV), and maintained with halothan...
Electroencephalographic and electromyographic changes during the use of detomidine and detomidine-butorphanol combination in standing horses. Clinically, the use of detomidine and butorphanol is suitable for sedation and deepening of analgosedation. The aim of our study was to establish the influence of detomidine used alone and a butorphanol-detomidine combination on brain activity and to evaluate and compare brain responses (using electroencephalography, EEG) by recording SEF90 (spectral edge frequency 90%), individual brain wave fractions (beta, alpha, theta and delta) and electromyographic (EMG) changes in the left temporal muscle in standing horses. Ten clinically healthy cold-blooded horses were divided into two groups of five...
Use of force plate analysis to assess the analgesic effects of etodolac in horses with navicular syndrome. To evaluate the musculoskeletal analgesic effect of etodolac administered PO every 12 or 24 hours in chronically lame horses by use of force plate analysis. Methods: 22 horses with navicular syndrome. Methods: Horses received etodolac (23 mg/kg, PO, q 12 h; n = 7), etodolac (23 mg/kg, PO, q 24 h; 8), or corn syrup (20 mL, PO, q 24 h; control treatment; 7) for 3 days. Combined forelimb peak vertical ground reaction force (PVF) was measured via force plate analysis before the first treatment (baseline) and at 6, 12, 24, and 36 hours after the last treatment. Differences in mean PVF (mPVF) betwee...
Use of ultrasonography to diagnose large colon volvulus in horses. To describe the use of ultrasonography to diagnose large colon volvulus (LCV) in horses. Methods: Descriptive report. Methods: 4 horses with clinical signs of abdominal pain. Methods: Each horse was administered analgesic agents for pain control and placed in stocks. Ultrasonographic evaluations were performed with a 3.5-MHz sector scanning transducer that was placed parallel to the long axis of the horse (longitudinal imaging) over an area of the left ventral aspect of the abdomen. The boundaries of the evaluated region included the ventral midline, 2 vertical lines at the level of the left 1...
Analgesic effects of epidural administration of hydromorphone in horses. To evaluate the effects of epidural administration of hydromorphone on avoidance threshold to noxious electrical stimulation of the perineal, sacral, lumbar, and thoracic regions in horses. Methods: 6 healthy adult horses. Methods: Horses were assigned to receive hydromorphone (0.04 mg/kg) or a control solution (20 mL of sterile water) administered epidurally into in the first intercoccygeal space. Treatments were administered at time intervals of > or = 7 days. Electrical stimulation was applied for 6 hours after epidural injection over the dermatomes of the perineal, sacral, lumbar, and t...
Effect of local analgesia on movement of the equine back. Diagnostic infiltration of local anaesthetic solution is commonly used in cases of equine back pain. Evaluation is subjective and it is not known how local analgesia of the back affects horses without clinical signs of back pain. Objective: To evaluate the effect of infiltration of local anaesthetics on the movement of the back in horses without clinical signs of back pain, and to evaluate the usefulness of kinematic studies as an objective and quantitative tool in evaluating local analgesia in clinical practice. Methods: The kinematics of the back in 10 clinically sound horses were measured o...
Intravenous continuous infusion of lidocaine for treatment of equine ileus. To determine if intravenous lidocaine is useful and safe as a treatment for equine ileus. Methods: Prospective double-blinded placebo-controlled trial. Methods: Horses (n = 32) with a diagnosis of postoperative ileus (POI) or enteritis and that had refluxed >20 L or had been refluxing for >24 hours. Methods: Refluxing horses were administered lidocaine (1.3 mg/kg intravenously [IV] as a bolus followed by a 0.05 mg/kg/min infusion) or saline (0.9% NaCl) solution placebo for 24 hours. Variables evaluated included volume and duration of reflux, time to 1st fecal passage, signs of pain, anal...
Evaluation of skin sensitivity after shock wave treatment in horses. To evaluate the effects of shock wave treatment on cutaneous nerve function, compared with the effects of local nerve block and sedation. Methods: 18 clinically sound Swiss Warmbloods. Methods: Horses were randomly allocated to 3 groups and received different amounts and types of shock waves (extracorporeal shock wave treatment [ESWT] or radial pressure wave treatment [RPWT]). Horses were sedated with xylazine and levomethadone. Shock waves were applied to the lateral palmar digital nerve at the level of the proximal sesamoid bones on 1 forelimb. Skin sensitivity was evaluated by means of an e...
Investigation of the immediate analgesic effects of extracorporeal shock wave therapy for treatment of navicular disease in horses. To measure the acute analgesic properties of extracorporeal shock wave therapy (ESWT) in horses with navicular disease using objective ground reaction forces (GRF). Methods: Prospective study. Methods: Nine client-owned horses with unilateral forelimb lameness caused by navicular disease. Methods: Horses were trotted at 3 m/s over a force plate to record pre-treatment GRF of the lame and contra-lateral forelimbs. After ESWT of the lame limb, applied with a radial unit to each of the frog and heel bulb areas with 1500 pulses at 4 bar and 10 Hz, GRF measurements were repeated at 15 minutes and 2...
