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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.
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...
Laparoscopic ovariectomy using the endo-GIA stapling device and endo-catch pouches and evaluation of analgesic efficacy of epidural morphine sulfate in 10 mares. To evaluate use of ENDO-GIA staples and ENDO-Catch pouches for ovariectomy in mares and to evaluate the efficacy of epidural morphine analgesia. Methods: Randomized clinical trial. Methods: Mares (n = 10) with normal ovaries. Methods: An Endo-GIA II stapler (United States Surgical Corp., Norwalk, CT) was used to amputate the ovaries bilaterally, in standing mares, and Endo-Catch II pouches (United States Surgical Corp.) were used for retrieval. Epidural morphine was used in 5 mares, and procedure duration, volume of lidocaine required to desensitize the ovarian pedicle, and sedation were compa...
Effect of romifidine on the nociceptive withdrawal reflex and temporal summation in conscious horses. To investigate the action of a single IV administration of romifidine on the thresholds of the nociceptive withdrawal reflex (NWR) and temporal summation in conscious horses. Methods: 10 adult horses. Methods: Single electrical stimulations were applied on the digital nerves to evoke NWR from the left forelimb and hind limb. Repeated electrical stimulations (10 stimuli, 5 Hz) were given to obtain temporal summation. Surface electromyographic reflex activity was recorded from the common digital extensor and cranial tibial muscles. After baseline assessment of NWR and temporal summation threshol...
Evaluation of analgesia resulting from extracorporeal shock wave therapy and radial pressure wave therapy in the limbs of horses and sheep. To identify the duration and potential mechanisms of analgesia following extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) in limbs of horses and sheep. Methods: 6 horses and 30 sheep. Methods: An electrical stimulus was used to identify the nociceptive threshold for each horse daily for 3 days before treatment (baseline) with ESWT or RPWT, 8 hours after treatment, and at 24-hour intervals for 7 days after treatment. Testing was conducted for the treatment field (midmetacarpus or midmetatarsus) and nerve field (medial and lateral forelimb heel bulbs) distal to a ...
Evaluation of electroacupuncture treatment of horses with signs of chronic thoracolumbar pain. To evaluate use of electroacupuncture for treatment of horses with signs of chronic thoracolumbar pain. Methods: Prospective study. Methods: 15 horses with signs of chronic thoracolumbar pain. Methods: Horses were randomly allocated to 1 of 3 treatment groups. Horses in group 1 received electroacupuncture stimulation (once every 3 days for 5 treatments), those in group 2 received phenylbutazone (2.2 mg/kg [1 mg/lb], PO, q 12 h, for 5 days), and those in group 3 received saline (0.9% NaCl) solution (20 mL, PO, q 12 h, for 5 days). Thoracolumbar pain scores (TPSs) were evaluated before (baseline...
In vitro evaluation of the effect of the opioid antagonist N-methylnaltrexone on motility of the equine jejunum and pelvic flexure. Although potent analgesics, opioids decrease intestinal activity, leading to ileus in many species. N-methylnaltrexone (MNTX), an opioid antagonist which does not cross the blood-brain barrier and antagonises the morphine effect on the intestine, directly stimulates motility and restores function without affecting analgesic properties. While its use has been reported in human subjects, there is no information with regard to its usage in the horse. Objective: To determine whether MNTX has an effect on contractile activity of the equine jejunum and pelvic flexure. Methods: Using circular smooth ...
Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. There is no current veterinary information with regard to data entry on a website. We therefore completed a prospective study on use of analgesics in relation to the need for abdominal surgery using a web-based survey instrument. Objective: To establish an internet-based data entry system that could be used to record prospective data on horses with colic. Objective: Failure of horses to respond to the initial administration of an analgesic is an indicator of the need for abdominal surgery. Methods: A survey was developed to determine if the response to administration of an analgesic during a v...
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, ...
