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Topic:Lidocaine
Lidocaine is a local anesthetic commonly used in equine medicine to manage pain and perform minor surgical procedures. It functions by blocking sodium channels, which inhibits nerve impulse conduction and results in temporary loss of sensation in targeted areas. In horses, lidocaine is utilized for various applications, including nerve blocks, epidural anesthesia, and as an adjunct in pain management protocols. Its pharmacokinetics, efficacy, and safety profile in equine patients are subjects of ongoing research. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacological properties, clinical applications, and potential side effects of lidocaine in horses.
Pressure profile in the caudal extradural space of standing horses before and after extradural drug administration. The objectives of this study were to measure the pressure in the caudal extradural space of standing horses and to evaluate the usefulness of pressure waves to identify correct needle placement. Caudal extradural pressure was measured in 12 healthy horses. The pressure and any extradural pressure waves were recorded for 3min after puncture, for 1min after testing for lack of resistance (LOR), and for 10min after lidocaine injection. Successful extradural drug administration was confirmed in all horses. The median extradural pressure findings after puncture, after LOR, immediately after injecti...
Attenuation of ischaemic injury in the equine jejunum by administration of systemic lidocaine. Absorption of endotoxin across ischaemic-injured mucosa is a major cause of mortality after colic surgery. Recent studies have shown that flunixin meglumine retards mucosal repair. Systemic lidocaine has been used to treat post operative ileus, but it also has novel anti-inflammatory effects that could improve mucosal recovery after ischaemic injury. Objective: Systemic lidocaine ameliorates the deleterious negative effects of flunixin meglumine on recovery of mucosal barrier function. Methods: Horses were treated i.v. immediately before anaesthesia with either 0.9% saline 1 ml/50 kg bwt, flun...
Serum concentrations of lidocaine and its metabolites after prolonged infusion in healthy horses. Continuous-rate infusions (CRI) of lidocaine are often used for prolonged duration but, to date, only limited time/concentration relationships administered as a short term (24 h) CRI have been reported. Objective: To determine the time/concentration profile of lidocaine and its active metabolites glycinexylidide (GX) and monoethylglycinexylidide (MEGX) during a 96 h lidocaine infusion. Methods: Lidocaine was administered to 8 mature healthy horses as a continuous rate infusion (0.05 mg/kg bwt/min) for 96 h. Blood concentrations of lidocaine, GX and MEGX were determined using high performance l...
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...
Lack of systemic absorption of lidocaine from 5% patches placed on horses. To measure concentrations of lidocaine serum after application of two 5% patches on horses. Methods: Prospective experimental trial Methods: Six client-owned, systemically healthy horses. Methods: The hair was clipped on the medial aspect above the carpus of both fore limbs and 2 patches of 5% lidocaine were applied within 30 minutes of jugular catheter placement and the area was then bandaged. Venous blood was drawn from a jugular vein catheter that was inserted using lidocaine as a local block. Samples were drawn immediately before and at 2, 4, 6, 8, and 12 hours after patch application. The...
Left- and right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. To describe a technique for, and outcome after, left- or right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. Methods: Clinical report. Methods: Horses (n=3) with unilateral renal disease. Methods: Horses were sedated with detomidine (0.01 mg/kg intravenously [IV]) and levomethadone (0.05 mg/kg IV). Paravertebral anesthesia and infiltration-anesthesia with 2% lidocaine were used to create a surgical field incorporating the 17th intercostal space and paralumbar fossa. Two separate, ipsilateral portals and a mini-laparotomy were used. The perirenal peri...
A clinical comparison of two anaesthetic protocols using lidocaine or medetomidine in horses. To compare the effects of two balanced anaesthetic protocols on end-tidal isoflurane (Fe'ISO), cardiopulmonary performance and quality of recovery in horses. Methods: Prospective blinded randomized clinical study. Methods: Sixty-nine client-owned horses, American Society of Anesthesiologists category I and II, undergoing elective surgery. Methods: The horses were premedicated with acepromazine (0.03 mg kg(-1)) IM 30-60 minutes before induction of anaesthesia and were randomly assigned to one of two treatments: in group L (37 horses) xylazine (1 mg kg(-1)) and in group M (31 horses) medetomidin...
The effect of lidocaine on postoperative jejunal motility in normal horses. To measure the effect of lidocaine on the duration of the migrating myoelectric complex (MMC) and Phases I, II, and III of the MMC, spiking activity of the jejunum, and number of Phase III events when administered postoperatively to normal horses. Methods: Nonrandomized cross-over design. Methods: Horses were anesthetized and via flank laparotomy 4 silver-silver chloride bipolar electrodes were sutured to the proximal jejunum. Electrical activity was recorded for 6 hours during 3 recording sessions beginning 24, 48, and 72 hours postoperatively. Saline (0.9% NaCl) solution was administered for...
Determination of lidocaine and its two N-desethylated metabolites in dog and horse plasma by high-performance liquid chromatography combined with electrospray ionization tandem mass spectrometry. A sensitive method for the quantification of lidocaine and its metabolites, monoethylglycinexylidide (MEGX) and glycinexylidide (GX), in animal plasma using high-performance liquid chromatography combined with electrospray ionization mass spectrometry is described. The sample preparation includes a liquid-liquid extraction with methyl tert-butylmethyl ether after addition of 2M sodium hydroxide. Ethylmethylglycinexylidide (EMGX) is used as an internal standard. For chromatographic separation, an ODS Hypersil column was used. Isocratic elution was achieved with 0.01 M ammonium acetate and aceto...
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])....
The disposition of lidocaine during a 12-hour intravenous infusion to postoperative horses. Lidocaine is administered as an intravenous infusion to horses for a variety of reasons, but no study has assessed plasma lidocaine concentrations during a 12-h infusion to horses. The purpose of this study was to evaluate the plasma concentrations and pharmacokinetics of lidocaine during a 12-h infusion to postoperative horses. A second purpose of the study was to evaluate the in vitro plasma protein binding of lidocaine in equine plasma. Lidocaine hydrochloride was administered as a loading dose, 1.3 mg/kg over 15 min, then by a constant rate IV infusion, 50 microg/kg/min to six postoperativ...
Effects of the bronchoalveolar lavage procedure on lung function in horses with clinical exacerbation of recurrent airway obstruction. To evaluate whether bronchoalveolar lavage (BAL) alters respiratory mechanics of horses with recurrent airway obstruction (ie, heaves) over a 48-hour period. Methods: 6 horses affected with heaves. Methods: Horses were subjected to a complete BAL procedure, which included sedation with xylazine and butorphanol, intratracheal administration of lidocaine, and instillation and aspiration of two 250-mL boluses of saline (0.9% NaCl) solution through an endoscope (study 1). To evaluate the effects of saline solution, horses were subjected to the same procedure without saline solution instillation an...
A comparison of N-butylscopolammonium and lidocaine for control of rectal pressure in horses. In its FDA approved formulation, N-butylscopolammonium bromide (Buscopan Injectable Solution, Boehringer Ingelheim Vetmedica) is an anticholinergic spasmolytic agent indicated for management of abdominal pain associated with spasmodic colic, flatulent colic, and simple impactions in horses. Use of this drug ablates gastrointestinal peristalsis and rectal pressure. It ahs been suggested that N-butylscopolammonium bromide could be used to facilitate rectal examinations in horses. This study compared the effects of N-butylscopolammonium bromide versus lidocaine and a saline control on rectal pres...
Effect of head position on intraocular pressure in horses. To evaluate the effect of head position on intraocular pressure (IOP) in horses. Methods: 30 horses. Methods: Horses were sedated with detomidine HCl (0.01 mg/kg, IV). Auriculopalpebral nerve blocks were applied bilaterally with 2% lidocaine HCl. The corneas of both eyes were anesthetized with ophthalmic 0.5% proparacaine solution. Intraocular pressures were measured with an applanation tonometer with the head positioned below and above heart level. The mean of 3 readings was taken for each eye at each position for data analysis. The effect of head position on IOP was assessed and generalized ...
Effect of intratesticular injection of lidocaine on cardiovascular responses to castration in isoflurane-anesthetized stallions. To evaluate the effect of intratesticular administration of lidocaine on cardiovascular responses and cremaster muscle tension during castration of isoflurane-anesthetized stallions. Methods: 28 healthy stallions (mean +/- SD age, 4.2 +/- 2.8 years) with no testicular abnormalities that were scheduled for castration. Methods: Each horse was given acepromazine (20 microg/kg, IM), romifidine (50 microg/kg, IV), and butorphanol (20 microg/kg, IV). Anesthesia was induced with ketamine (2.5 mg/kg, IV) and midazolam (50 microg/kg, IV) and maintained with isoflurane (1.7% end-tidal concentration). Af...
Influence of gastrointestinal tract disease on pharmacokinetics of lidocaine after intravenous infusion in anesthetized horses. To determine the disposition of lidocaine after IV infusion in anesthetized horses undergoing exploratory laparotomy because of gastrointestinal tract disease. Methods: 11 horses (mean +/- SD, 10.3 +/- 7.4 years; 526 +/- 40 kg). Methods: Lidocaine hydrochloride (loading infusion, 1.3 mg/kg during a 15-minute period [87.5 microg/kg/min]; maintenance infusion, 50 microg/kg/min for 60 to 90 minutes) was administered IV to dorsally recumbent anesthetized horses. Blood samples were collected before and at fixed time points during and after lidocaine infusion for analysis of serum drug concentration...
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...
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 a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses. Lidocaine constant rate infusions (CRIs) are common as an intraoperative adjunct to general anaesthesia, but their influence on quality of recovery has not been thoroughly determined. Objective: To determine the effects of an intraoperative i.v. CRI of lidocaine on the quality of recovery from isoflurane or sevoflurane anaesthesia in horses undergoing various surgical procedures, using a modified recovery score system. Objective: The administration of intraoperative lidocaine CRI decreases the quality of recovery in horses. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 microg/kg bwt/min...
Effects of antitussive agents administered before bronchoalveolar lavage in horses. To determine whether treatment of horses with antitussive agents before bronchoalveolar lavage (BAL) reduces the frequency and intensity of the cough reflex during BAL. Methods: 8 healthy horses. Methods: Standard BAL was performed on each horse weekly for 6 weeks. Detomidine was used as a general sedative, and various antitussive agents were evaluated for their suitability to suppress undesirable coughing. Treatments administered prior to BAL consisted of saline (0.9% NaCl) solution (control treatment), codeine, butorphanol tartrate, glycopyrrolate, lidocaine hydrochloride (final concentratio...
Intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy. To compare intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy. Methods: Randomized controlled trial. Methods: 15 mares between 4 and 20 years old. Methods: Standard bilateral laparoscopic ovariectomy was performed. Prior to manipulation of the ovary, 2% lidocaine (10 mL) was injected into the ovary and saline (0.9% NaCI) solution (10 mL) was injected into the mesovarium on 1 side, with saline solution (10 mL) injected into the ovary and 2% lidocaine (10 mL) injected into the mesovarium on the other side. Pr...
Investigation of the EEG effects of intravenous lidocaine during halothane anaesthesia in ponies. To record the electroencephalographic changes during castration in ponies anaesthetized with halothane and given intravenous (IV) lidocaine by infusion. The hypothesis tested was that in ponies, IV lidocaine is antinociceptive and would therefore obtund EEG changes during castration. Methods: Ten Welsh mountain ponies referred to the Department of Clinical Veterinary Medicine, Cambridge for castration under general anaesthesia. Methods: Following pre-anaesthetic medication with intramuscular acepromazine (0.02 mg kg(-1)) anaesthesia was induced with IV guaiphenesin (60 mg kg(-1)) and thiopenta...
Comparison of topical lidocaine/prilocaine anesthetic cream and local infiltration of 2% lidocaine for episioplasty in mares. Local anesthesia and tissue inflammation associated with lidocaine infiltration and lidocaine/prilocaine topical anesthetic cream for episioplasty in mares were compared. Twenty-two mares were randomly assigned to lidocaine or lidocaine/prilocaine topical anesthetic cream treatment groups. Perineum and vulva were cleaned, 8-12 g (approximately 1 g/cm per side of vulva) of topical anesthetic cream was applied, and the area was covered by plastic wrap 30 min prior to beginning procedure. Alternately, lidocaine was injected (1 mL) every centimeter just prior to the procedure. Episioplasty was con...
Influence of general anesthesia on pharmacokinetics of intravenous lidocaine infusion in horses. To compare the disposition of lidocaine administered IV in awake and anesthetized horses. Methods: 16 horses. Methods: After instrumentation and collection of baseline data, lidocaine (loading infusion, 1.3 mg/kg administered during 15 minutes (87 microg/kg/min); constant rate infusion, 50 microg/kg/min) was administered IV to awake or anesthetized horses for a total of 105 minutes. Blood samples were collected at fixed times during the loading and maintenance infusion periods and after the infusion period for analysis of serum lidocaine concentrations by use of liquid chromatography with mass...
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...
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...
Evaluation of risk factors associated with development of postoperative ileus in horses. To determine factors associated with development of postoperative ileus (POI) in horses undergoing surgery for colic. Methods: Prospective case-control study. Methods: 251 horses undergoing colic surgery, of which 47 developed POI. Methods: Signalment, history, clinicopathologic data, pre- and postoperative treatments, lesions, complications, costs, and outcome were recorded for all horses during hospitalization. Results: Variables associated with increased odds of POI included small intestinal lesion, high PCV, and increased duration of anesthesia. There was modest evidence that pelvic flexur...
Diagnostic anaesthesia of the equine lower limb: a comparison of lidocaine and lidocaine with epinephrine. The anaesthetic potency, onset of action, duration of action, and side effects of lidocaine and lidocaine plus epinephrine for proximal metacarpal block of the lateral and medial palmar nerves were determined. Ten horses were used and legs were injected using a cross-over model with three test solutions: 1) solvent and lidocaine (2%) plus epinephrine (SLE); 2) solvent and lidocaine (2%) without epinephrine (SL); and 3) solvent only (S). The contra-lateral leg was injected with saline (placebo; P). In both the SL and SLE groups, the onset of anaesthesia occurred between 5 and 15 minutes after i...
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...
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...
