Topic:Local Anaesthesia
Local anaesthesia in horses involves the administration of agents that temporarily block nerve conduction, resulting in a loss of sensation in a specific area of the body. This technique is employed in various veterinary procedures to facilitate pain management and allow for the performance of minor surgical interventions without the need for general anaesthesia. Common local anaesthetic agents used in equine medicine include lidocaine, mepivacaine, and bupivacaine. These agents are selected based on their duration of action and specific application requirements. The use of local anaesthesia can help minimize stress and recovery time for horses undergoing treatment. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, application methods, and clinical outcomes associated with local anaesthesia in equine practice.
Effects of triamcinolone acetonide, sodium hyaluronate, amikacin sulfate, and mepivacaine hydrochloride, alone and in combination, on morphology and matrix composition of lipopolysaccharide-challenged and unchallenged equine articular cartilage explants. To evaluate the effects of triamcinolone acetonide (TA), sodium hyaluronate (HA), amikacin sulfate (AS), and mepivacaine hydrochloride (MC) on articular cartilage morphology and matrix composition in lipopolysaccharide (LPS)-challenged and unchallenged equine articular cartilage explants. Methods: 96 articular cartilage explants from 4 femoropatellar joints of 2 adult horses. Methods: Articular cartilage explants were challenged with LPS (100 ng/mL) or unchallenged for 48 hours, then treated with TA, HA, AS, and MC alone or in combination for 96 hours or left untreated. Cartilage extracts were...
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...
Transpalpebral eye enucleation in 40 standing horses. To report a technique for eye enucleation in standing sedated horses and to report outcome in 40 horses. Methods: Retrospective study. Methods: Horses (n=40) requiring eye enucleation. Methods: The eye was enucleated using a transpalpebral technique in 40 horses restrained in stocks and sedated. Anesthesia of orbital structures was provided by local nerve blocks and infiltration of the surgical site with local anesthetic solution. Results: Affected eyes were successfully enucleated with the horse standing. Short-term complications included moderate swelling (5 horses) and wound discharge (1). ...
Simulation of local anaesthetic nerve block of the infraorbital nerve within the pterygopalatine fossa: anatomical landmarks defined by computed tomography. To provide anaesthesia of the maxillary cheek teeth, a local block of the infraorbital nerve in the pterygopalatine fossa has been suggested. The aim of this study was to re-examine the anatomy of the pterygopalatine fossa, giving special attention to relevant arteries, veins and nerves; simulate the infiltration of an anaesthetic by injecting a contrast medium; improve the injection technique to avoid puncturing of relevant anatomical structures. Five heads and two living horses were investigated using contrast medium injections and computed tomography (CT). Needles were inserted using two in...
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...
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 ...
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...
Standing enucleation in the horse: a report of 5 cases. Enucleation was performed in 5 horses under local anesthesia and sedation with the horse standing. Minimal hemorrhage occurred during the surgical procedure, and there were no other reported complications. Standing enucleation is a surgery that is safe to perform in horses. L’énucléation a été réalisée chez 5 chevaux en position debout sous anesthésie locale et sédation. Une hémorragie minime est survenue pendant la procédure chirurgicale et il n’y a pas eu de complications rapportées. L’énucléation debout est une chirurgie sécuritaire chez le cheval. (Traduit par Docteur ...
Standing surgical repair of propagating metacarpal and metatarsal condylar fractures in racehorses. Repair of spiral and long diaphyseal metacarpal and metatarsal fractures under anaesthesia can be problematic and associated with a high incidence of complications, including fracture propagation necessitating euthanasia. Objective: To report on a practical repair technique for which general anaesthesia is not required. Methods: Thirteen racehorses with a spiral/propagating condylar fracture had the fracture repaired using local anaesthesia and sedation, without the need for general anaesthetic. Results: Ten of the horses returned to training and 8 raced again. Two horses were retired directly...
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...
Evaluation of a vessel-sealing device for laparoscopic granulosa cell tumor removal in standing mares. To describe a laparoscopic technique for granulosa cell tumor removal using a vessel sealing device (LigaSuretrade mark) in standing mares. Methods: Retrospective study. Methods: Eight mares (8-24 years old; weighing, 406-525 kg). Methods: Before surgery, ovarian size and adjacent body wall thickness was determined by ultrasonography. Mares were sedated and after local anesthesia (inverted L and local infiltration), laparoscopic cannulation was performed without insufflation. The mesovarium was anesthetized and the LigaSure instrument applied to the mesovarium for hemostasis and resection to r...
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...
Tracheal perforation managed by temporary tracheostomy in a horse. Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by...
Recent advances in equine abdominal surgery. Laparoscopy is a minimally invasive procedure that has applications as a diagnostic, therapeutic and prognostic technique. Specialized equipment is necessary to perform equine laparoscopy, and there is a large range of instruments, both disposable and non-disposable available. Laparoscopic procedures described include ovariectomy, cryptorchidectomy, adhesiolysis and herniorrhaphy. Laparoscopy can be performed in a standing or dorsally recumbent position, depending on surgeon preference, patient status and the procedure to be performed. Stapling equipment is frequently used in gastrointestinal ...
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...
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...
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...
Complications associated with cannula insertion techniques used for laparoscopy in standing horses. To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses. Methods: Retrospective study. Methods: Forty horses that had laparoscopy for diagnostic or surgical purposes. Methods: After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1, n = 3) or a 12-g catheter (g...
Effect of alkalinization on the local analgesic efficacy of ketamine in the abaxial sesamoid nerve block in horses. The objective of this study was to determine the effects of the alkalinization on the local analgesic efficacy of 1% ketamine in the abaxial sesamoid nerve block in horses. Thirty-six mature healthy horses were randomly assigned to four groups for the following treatments; an abaxial sesamoid block with 5 mL of saline solution (control saline); an abaxial sesamoid block with 5 mL of a solution containing 1% ketamine (KETs 1%); an abaxial sesamoid block with 5 mL of a solution containing saline solution and 0.5 mEq of sodium bicarbonate (control bicarbonate); and an abaxial sesamoid block with ...
The effects of local anaesthetic solution in the navicular bursa of horses with lameness caused by distal interphalangeal joint pain. Analgesia of the palmar digital (PD) nerves has been demonstrated to cause analgesia of the distal interphalangeal (DIP) joint as well as the sole. Because the PD nerves lie in close proximity to the navicular bursa, we suspected that that analgesia of the navicular bursa would anaesthetise the PD nerves, which would result in analgesia of the DIP joint. Objective: To determine the response of horses with pain in the DIP joint to instillation of local anaesthetic solution into the navicular bursa. Methods: Lameness was induced in 6 horses by creating painful synovitis in the DIP joint of one f...
Hand-assisted laparoscopic left nephrectomy in standing horses. To describe a hand-assisted, laparoscopic technique to remove the left kidney in standing horses. Methods: Prospective evaluation. Methods: Eight horses. Methods: Food was withheld for a minimum of 12 hours. Horses were sedated with detomidine hydrochloride (0.01-0.02 mg/kg, intravenously) and restrained in standing stocks. The left paralumbar fossa was prepared for surgery, and the surgical site was infiltrated with 2% mepivacaine. Hand-assisted, laparoscopic removal of the left kidney was performed through an incision in the center of the paralumbar fossa; the surgeon's hand was used to isol...
The effect of perineural anesthesia on infrared thermographic images of the forelimb digits of normal horses. Infrared thermography is an imaging modality gaining popularity as a diagnostic aid in the evaluation of equine lameness. Anecdotal reports of skin hyperthermia induced by local anesthesia, detected by thermography, have been made; however, no controlled studies have been reported. The purpose of this study was to examine the effects of perineural anesthesia on infrared thermographic images of the forelimb digits in normal horses. After environmental acclimation, infrared thermographs were made at intervals of 0, 5, 10, 15, 30, and 45 min from administration of mepivacaine hydrochloride or pho...
Pain associated with the sacroiliac joint region: a clinical study of 74 horses. There has been no large study of horses with suspected sacroiliac (SI) joint region pain in which the clinical diagnosis has been supported by either abnormal radiopharmaceutical activity in the SI joint region or by periarticular infiltration of local anaesthetic solution. Objective: To describe the clinical features of horses with SI joint region pain, to document the age, breed, sex, discipline, size and conformation of affected horses and to compare these with the author's (SD) normal case population and to document the results of infiltration of local anaesthetic solution around the SI jo...
Evaluation of the local analgesic effect of ketamine in the palmar digital nerve block at the base of the proximal sesamoid (abaxial sesamoid block) in horses. To evaluate the local analgesic effect of ketamine in a palmar digital nerve block at the base of the proximal sesamoid (abaxial sesamoid block) in horses. Methods: 36 mature healthy Andalusian horses. Methods: Horses were randomly assigned to 4 groups of 9 horses each and received an abaxial sesamoid block in a randomly chosen forelimb with 1 of the following: saline (0.9% NaCl) solution, 1% ketamine solution, 2% ketamine solution, or 3% ketamine solution. To determine analgesia, the radiant heat lamp-hoof withdrawal model was used as a noxious thermal stimulus. Before each nerve block, basel...
Effect of perineural anesthesia on the ultrasonographic appearance of equine palmar metacarpal structures. The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% m...
Epidural anesthesia and analgesia in horses. Intercoccygeal, or caudal, epidural injection of local anesthetics is a convenient method of producing analgesia and local anesthesia of the tail and perineal structures in conscious standing horses. This technique has been further developed to provide long duration analgesia and anesthesia by placement of catheters into the epidural space of horses. More recently, opioid, alpha-2 adrenergic agonists, ketamine and other analgesic agents have been administered by caudal epidural injection, providing pain relief in both conscious, standing and anesthetized, recumbent horses. This chapter describ...
Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 1: forelimb foot and carpus. This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the forelimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the distal interphalangeal joint (DIPJ) and navicular bursa (NB) of the forelimbs and between the intercarpal (IC) and radiocarpal (RC) joints of 31 fresh equine cadavers. The DIPJ of one forelimb and the NB of the contra lateral forelimb and the RC joint of one forelimb and the IC joint of the contra lateral forelimb were ...
Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 2: tarsus and stifle. This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the hindlimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the tarsometatarsal, centrodistal and tarsocrural joints, and the 3 synovial compartments of the stifle in 33 fresh equine cadavers. The tarsometatarsal joint and one synovial compartment of the stifle in the left limb and the centrodistal joint and a different synovial compartment of the stifle in the right limbs were inje...
A comparison of the effects of local analgesic solution in the navicular bursa of horses with lameness caused by solar toe or solar heel pain. We hypothesised that analgesia of the navicular bursa is not selective for the navicular apparatus; and that solar pain in some horses can be temporarily abolished or attenuated by analgesia of the navicular bursa. To test this hypothesis, we caused lameness in horses by inducing pain in the dorsal margin or the angles of the sole and then evaluated the ability of a local analgesic solution administered into the navicular bursa to attenuate lameness. The response of horses with solar pain in the dorsal or palmar aspect of the foot to 3.5 ml local analgesic solution administered into the navicu...
Ropivacaine in the horse: its pharmacological responses, urinary detection and mass spectral confirmation. This report evaluates the pharmacological responses, urinary detection and mass spectral confirmation of ropivacaine in horses. Ropivacaine, a potent local anesthetic (LA) recently introduced in human medicine, has an estimated highest no-effect dose (HNED) of about 0.4 mg/site as determined in our abaxial sesamoid block model. Apparent ropivacaine equivalents were detectable by ELISA screening using a mepivacaine ELISA test after administration of clinically effective doses. Mass spectral examination of postadministration urine samples showed no detectable parent ropivacaine, but a compound i...