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.
L-Bupivacaine 0.5% vs. racemic 0.5% bupivacaine for caudal epidural analgesia in horses. Bupivacaine is available as a racemic mixture of its enantiomers, d-bupivacaine and l-bupivacaine (LB). The aim of this randomized, double-blind study was to investigate the clinical efficacy and safety of S(-)-bupivacaine compared with standard racemic bupivacaine (RB) in horses under caudal epidural analgesia. Two treatments were administered to each horse, with a 2-week interval between subsequent treatments. Treatment 1 consisted of 0.5% LB at a dose of 0.06 mg/kg of body weight, and treatment 2 consisted of 0.5% RB at a dose of 0.06 mg/kg of body weight. Epidural injections were given in ...
Effect of systemic lidocaine on visceral and somatic nociception in conscious horses. Commonly used analgesics (nonsteroidal anti-inflammatory agents, opioids and alpha2-agonists) have unwanted side effects. An effective alternative with minimal adverse effects would benefit clinical equine pain management. Objective: To compare the effect of lidocaine or saline on duodenal and rectal distension threshold pressure and somatic thermal threshold in conscious mature horses. Objective: Systemically administered lidocaine would increase somatic and visceral nociceptive thresholds. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 microg/kg bwt/min for 2 h) or saline was administe...
Use of force plate analysis to compare the analgesic effects of intravenous administration of phenylbutazone and flunixin meglumine in horses with navicular syndrome. To use force plate analysis to evaluate the analgesic efficacies of flunixin meglumine and phenylbutazone administered i.v. at typical clinical doses in horses with navicular syndrome. Methods: 12 horses with navicular syndrome that were otherwise clinically normal. Methods: Horses received flunixin (1.1 mg/kg), phenylbutazone (4.4 mg/kg), or physiologic saline (0.9% NaCI; 1 mL/45 kg) solution administered IV once daily for 4 days with a 14-day washout period between treatments (3 treatments/horse). Before beginning treatment (baseline) and 6, 12, 24, and 30 hours after the fourth dose of each...
Pharmacokinetics and synovial fluid concentrations of flurbiprofen enantiomers in horses: chiral inversion. Flurbirpofen (FBP), a member of the 2-aryl propionate nonsteroidal anti-inflammatory drug class, has potent anti-inflammatory and analgesic properties. The commercial preparation is a racemic mixture of the R(-) and S(+) enantiomers of FBP. In this study, R(-) and S(+) FBP were used to investigate the metabolic chiral inversion. Each enantiomer was administered separately (0.25 mg/kg) and in a racemic mixture (0.5 mg/kg) intravenously to horses. Plasma and synovial concentration of each enantiomer was determined and the disposition of each was analyzed. After intravenous administration of R(-)...
Evaluation of the analgesic effects of phenylbutazone administered at a high or low dosage in horses with chronic lameness. To compare analgesic effects of phenylbutazone administered at a dosage of 4.4 mg/kg/d (2 mg/lb/d) or 8.8 mg/kg/d (4 mg/lb/d) in horses with chronic lameness. Methods: Controlled crossover study. Animals-9 horses with chronic forelimb lameness. Methods: Horses were treated i.v. with phenylbutazone (4.4 mg/kg/d or 8.8 mg/kg/d) or saline (0.9% NaCl) solution once daily for 4 days. All horses received all 3 treatments with a minimum of 14 days between treatments. Mean peak vertical force (mPVF) was measured and clinical lameness scores were assigned before initiation of each treatment and 6, 12, ...
Current practice relating to equine castration in the UK. This study aimed to characterise current practice relating to equine castration in the UK. A questionnaire was posted to all 655 veterinary practices specified to provide veterinary care for horses, or classified as specialist equine practices. Respondents were asked to cite the number of equine castrations performed annually by the practice, describe techniques used for castration, outline anaesthetic/sedative/analgesic drug protocols used and provide details of post-operative medication. There was a 43% response rate to the questionnaire. Considerable variation in techniques and analgesia pr...
Equine dental advances. The reintroduction and development of safe motorized instruments, the increased availability of continuing education, and the understanding and implementation of appropriate procedures allow practitioners to provide better dental care. Veterinarians realize that sedation, analgesia, a full-mouth speculum, and proper instrumentation are necessary to provide these services. Continued instrument design, future research, and new treatment and prophylactic protocols should have a positive impact on the future of equine dental health. New and rediscovered procedures for equilibrating equine occlusio...
Mepivacaine local anaesthetic duration in equine palmar digital nerve blocks. Perineural analgesics are used for lameness diagnosis but the duration of effect, knowledge of which would provide valuable information when performing subsequent blocks, is unknown. Objective: To evaluate the duration of a palmar digital nerve block using force plate measurements. Methods: Ten horses diagnosed with unilateral navicular syndrome were trotted at range of 3 +/- 0.15 m/sec over a force plate to record ground reaction forces for 5 trials of each forelimb. Data were recorded before nerve block, and then at 15 mins, 1, 2 and 24 h post nerve block. Results: Before nerve block, peak v...
Colorectal distention in the horse: visceral sensitivity, rectal compliance and effect of i.v. xylazine or intrarectal lidocaine. Most current models of visceral sensitivity testing in the horse have required visceral cannulation. Colorectal distention (CRD) is a widely used, noninvasive method for testing in other species and could be adapted for use in horses. Objective: To develop a protocol of controlled CRD in the conscious horse and to evaluate the effect of i.v. xylazine or intrarectal lidocaine on CRD threshold and rectal compliance. Methods: Eight horses were used for baseline studies (3 trials each) and 6 horses to evaluate treatments (4 trials, 2 per treatment). A 45 cm diameter polyvinyl balloon attached to p...
Determination of functional and morphologic changes in palmar digital nerves after nonfocused extracorporeal shock wave treatment in horses. To determine functional and morphologic changes in palmar digital nerves after nonfocused extracorporeal shock wave (ESW) treatment in horses. Methods: 6 horses. Methods: The medial and lateral palmar digital nerves of the left forelimb were treated with nonfocused ESWs. The medial palmar digital nerve of the right forelimb served as a nontreated control nerve. At 3, 7, and 35 days after treatment, respectively, 2 horses each were anesthetized and nerves were surgically exposed. Sensory nerve conduction velocities (SNCVs) of treated and control nerves were recorded, after which palmar digital ...
Evaluation of cutaneous analgesia after non-focused extracorporeal shock wave application over the 3rd metacarpal bone in horses. Extracorporeal shock wave therapy is becoming increasingly used in equine practice to treat musculoskeletal disorders. Although the exact effects of extracorporeal shock waves on tissues still need to be elucidated, transient cutaneous analgesia has been observed within treated areas in humans and horses. The purpose of this study was to determine the onset, magnitude, and duration of cutaneous analgesia after non-focused extracorporeal shock wave (ESW) application by comparing the limb withdrawal reflex latency (LWRL) in treated and untreated areas on the metacarpus of horses, using a focused...
An analgesic evaluation of isoxsuprine in horses. Isoxsuprine is used clinically to treat navicular disease and laminitis in horses. Although it is thought to increase digital and laminar blood flow, isoxsuprine's mechanism of action remains controversial, and analgesia has been suggested recently as such possible mechanism. This research investigated the analgesic potential of isoxsuprine in healthy horses submitted to a mechanical nociceptive test. Isoxsuprine (1.2 mg/kg), xylazine (1.1 mg/kg), distilled water : ethanol 95% (2 : 1, v/v, 20 ml) and saline (0.9%, 20 ml) were injected intravenously, and nociceptive thresholds were measured ove...
Transdermal fentanyl combined with nonsteroidal anti-inflammatory drugs for analgesia in horses. This study investigated the pharmcokinetics, efficacy, and safety of the fentanyl transdermal therapeutic system (TTS) in horses in which there was an inadequate analgesic response to nonsteroidal anti-inflammatory drugs (NSAIDs) alone. Nine horses with pain that was refractory to therapeutic doses of phenylbutazone (n = 3) or flunixin meglumine (n = 6) subsequently also received between 39 and 110 microg/kg of transdermal fentanyl. Blood samples were collected at 0, 1, 2, 3, 4, 5, 6, 12, 24, 36, 48, 60, and 72 hours after patch application, and a radioimmunoassay was used to determine serum f...
Standing sedation and pain management for ophthalmic patients. Several ocular procedures, including examination, removal of corneal foreign bodies, nictitans surgery, eyelid repair, and tumor excision,can be successfully performed in the appropriately restrained and sedated standing horse. Sedation is best achieved with xylazine,with or without the addition of acepromazine. Additional analgesia can be provided with appropriate local anesthetic blocks. Surgical conditions are greatly improved by using an auriculopalpebral and supraorbital block and topical anesthetics. More elaborate standing sedation involving continuous rate infusions of lidocaine or det...
Effects of epidural opioid analgesics on heart rate, arterial blood pressure, respiratory rate, body temperature, and behavior in horses. Heart rate, arterial blood pressures, respiratory rate, body temperature, and central nervous system excitement were compared before and after epidural administration of morphine (0.1 mg/kg), butorphanol (0.08 mg/kg), alfentanil (0.02 mg/kg), tramadol (1.0 mg/kg), the k-opioid agonist U50488H (0.08 mg/kg), or sterile water using an incomplete Latin square crossover design in five conscious adult horses. Treatments were administered into the first intercoccygeal epidural space. Significant (P <.05) reductions in respiratory rate were detected after epidural administration of morphine, alfent...
Comparison of ropivacaine with a combination of ropivacaine and fentanyl for the caudal epidural anaesthesia of mares. Two groups of six mares aged from eight to 18 years were anaesthetised by caudal epidural injections of ropivacaine (0.5 per cent, 0.1 mg/kg) or a combination of ripovacaine (0.08 mg/kg) and fentanyl (100 microg) in a randomised study. The onset of anaesthesia was significantly more rapid (P<0.001) and it lasted significantly longer (P<0.001) in the group anaesthetised with the combination of drugs. The surgical comfort scores of the group anaesthetised with the combination were higher than those of the group anaesthetised with ropivacaine alone (P<0.001), and the quality of intraoper...
Postoperative management of the large colon volvulus patient. Horses with large colon volvulus (LCV) often require intensive postoperative medical management. Although early referral and surgical intervention are critical for minimal postoperative complications and a successful outcome, this is often not possible for many reasons. Endotoxemia, extensive mucosal damage with subsequent severe hypoproteinemia, and focal ischemic necrosis are the major causes of postoperative morbidity and mortality. Although fluid therapy, flunixin meglumine, and antimicrobials are still the mainstay of perioperative management, synthetic colloids are being used to maintain...
Epidural administration of tiletamine/zolazepam in horses. To evaluate the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses. Methods: Prospective, double-blind, randomized experimental study. Methods: Five adult, healthy horses aged 10-16 years and weighing (mean +/- SD) 400 +/- 98 kg. Methods: The horses were sedated with 1.0 mg kg(-1) intravenous (IV) xylazine, and an epidural catheter was placed into the first intercoccygeal intervertebral space. After a 48-hour resting period, epidural tiletamine/zolazepam, 0.5 mg kg(-1) (treatment I) or 1.0 mg kg(-1) (treatment II), diluted up to 5 mL...
Collateral desmitis of the distal interphalangeal joint in 18 horses (2001-2002). There have been no previously published case series of horses examined using either scintigraphy or MRI to diagnose collateral ligament injuries not detectable using ultrasonography or radiography, nor have other concurrent soft tissue lesions been described. Objective: To describe the clinical features of horses with desmitis of the collateral ligaments of the distal interphalangeal (DIP) joint and to evaluate the results of radiographic, ultrasonographic, scintigraphic and magnetic resonance imaging (MRI) examinations. Methods: Horses were examined between January 2001 and January 2003 and w...
Perineal analgesia and hemodynamic effects of the epidural administration of meperidine or hyperbaric bupivacaine in conscious horses. Epidural administration of bupivacaine and meperidine produces analgesia in several animal species and in humans. A prospective randomized study was conducted in 18 healthy horses to compare the effect of these 2 drugs administered by the epidural route. Animals were divided into 3 treatment groups of 6 animals each. All drugs were injected by the epidural route in all animals between the 1st and 2nd coccygeal vertebrae. Treatment 1 (BUP)--0.06 mg/kg of body weight of 0.5% hyperbaric bupivacaine; treatment 2 (MEP)--0.6 mg/kg of body weight of 5% meperidine; treatment 3 (SS)--0.9% saline soluti...
Lameness in 46 horses associated with deep digital flexor tendonitis in the digit: diagnosis confirmed with magnetic resonance imaging. The differential diagnosis of foot pain has long proved difficult and the use of magnetic resonance imaging (MRI) offers the opportunity to further the clinical understanding of the subject. Objective: To determine the incidence of deep digital flexor tendon (DDFT) injuries in a series of 75 horses with lameness associated with pain localised to the digit, with no significant detectable radiographic or ultrasonographic abnormalities, using MRI; and to describe a variety of lesion types and relate DDF tendonitis with anamnesis, clinical features, response to local analgesic techniques and nucle...
Foot pain and the elusive diagnosis. New information about foot anatomy, effects of local analgesia, and advances in diagnostic imaging (ultrasonography, nuclear scintigraphy, MRI, CT, and endoscopy) has opened the way for more specific diagnoses of lameness. New questions have been raised, however, and some older ideas are now in doubt. This article discusses some of these findings in the light of our own clinical experiences as they relate to diagnosis of the causes of foot pain.
A comparison of the antinociceptive effects of xylazine, detomidine and romifidine on experimental pain in horses. To study the analgesic potency of the alpha2-agonist romifidine in the horse using both an electrical current and a mechanical pressure model for nociceptive threshold testing. In addition, a comparison was made with doses of detomidine and xylazine that produce equivalent degrees of sedation. Methods: Randomized, placebo-controlled, blinded cross-over study. Methods: Six adult Swiss warmblood horses, one mare and five geldings, weighing from 530 to 650 kg and aged 6-15 years. Methods: Nociceptive thresholds were measured using an electrical stimulus applied to the coronary band and using a pn...
Analgesic, behavioral, and hemodynamic and respiratory effects of midsacral subarachnoidally administered ropivacaine hydrochloride in mares. To determine the analgesic, behavioral, hemodynamic and respiratory effects of midsacral subarachnoid administration of ropivacaine hydrochloride solution in mares. Methods: Randomized, blinded study. Methods: Ten healthy mares, weighing from 470 to 560 kg. Methods: Intravascular and subarachnoid catheters were placed after infiltration of the skin and subcutaneous tissues with 2% lidocaine. Ropivacaine (0.2%, 5 mL) or 0.9% NaCl was then administered subarachnoidally at the midsacral (S2-S3) vertebrae. Analgesia was determined by lack of sensory perception to electrical stimulation (>40 mA)...
Problems associated with perioperative morphine in horses: a retrospective case analysis. To identify the incidence of adverse effects caused by morphine 100-170 micro g kg-1 administration during surgery in horses. Methods: Retrospective case record analysis (1996-2000). Methods: Eighty-four healthy (ASA 1 or 2) horses, mean age 5.5 +/- 3.1 (SD) years (2 months to 16 years), mean weight 524 +/- 14 kg (100-950). Methods: Physiological data and evidence of complications were collected from the anaesthetic records of all animals anaesthetized with romifidine, ketamine, diazepam and halothane and undergoing laryngeal surgery or orchiectomy at the Royal (Dick) School of Veterinary Stud...
A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse. To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse. Methods: A blinded, randomized, prospective, experimental cross-over study. Methods: Seven healthy horses, 15.7 +/- 4.9 years (mean +/- SD) of age, weighing 536 +/- 37 kg. Methods: The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg-1 or group L: LIDO, 0.35 mg kg-1) at intervals of at least 28 days. An 18-gauge 80-mm Tuohy epidura...
Effects of topical perineural capsaicin in a reversible model of equine foot lameness. Capsaicin is a local substance P depleter with dramatic analgesic effects. We tested the hypothesis that the topical application of capsaicin ointment over the palmar digital nerves would attenuate the clinical effects of a reversible model of equine foot lameness. Seven healthy adult horses shod unilaterally with adjustable heart bar shoes were studied in a crossover design for 2 weeks. Grade 5.0/5.0 lameness (nonweight bearing) was induced by tightening the adjustable heart bar shoe. One hour later, capsaicin ointment was applied over the medial and lateral palmar digital nerves 3 cm proxima...