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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.
A comparison of the effects of two volumes of local analgesic solution in the distal interphalangeal joint of horses with lameness caused by solar toe or solar heel pain. The response of horses, with solar pain in the dorsal or palmar aspect of the foot, to 6 or 10 ml local analgesic solution administered into the distal interphalangeal (DIP) joint was examined. Lameness was induced in 7 horses by creating solar pain in the dorsal aspect of one forefoot and, at another time, the palmar aspect of the other forefoot with set-screws inserted into a custom-made shoe. Horses were videotaped trotting before and after application of set-screws and, in separate trials, after 6 or 10 ml local analgesic solution was administered into the DIP joint. Lameness scores were a...
Studies on the experimental induction of ptosis in horses. The precise appearance of ptosis due to lesions at different sites was investigated in experimental ponies. The angles of the eyelashes to the head was used as an objective measurement of ptosis after local anaesthesia of the sympathetic trunk or the palpebral nerve and the administration of an ocular alpha agonist or antagonist. It was shown that ptosis is not an inevitable consequence of palpebral nerve pathology, that ocular alpha antagonists can induce ptosis, and that alpha agonist eyedrops have an inconsistent effect on the equine pupil, but are consistent at reversing ptosis induced by ...
Identification of hydroxyropivacaine glucuronide in equine urine by ESI+/MS/MS. Ropivacaine is a local anesthetic that has a high potential for abuse in racing horses. It can be recovered from urine collected after administration as a hydroxylated metabolite following beta-glucuronidase treatment of the urine. Based on these findings, it has been inferred that ropivacaine is present in equine urine as a glucuronide metabolite; however, these metabolites have never been directly identified. Using ESI+/MS/MS, the presence of a [M+H]+ molecular ion of m/z 467 was demonstrated in urine corresponding to the calculated mass of a hydroxyropivacaine glucuronide +1. The abundance ...
Sternal bone biopsy in standing horses. To develop a technique for sternal bone biopsy in standing horses. Methods: Experimental study. Methods: Five adult horses. Methods: Horses were restrained in a standing stocks and sedated. The sternal biopsy site, identified by ultrasonographic examination, was clipped and prepared for aseptic surgery and infiltrated with local anesthetic. An electric bone biopsy drill (Osteocore; Institut Straumann AG, CH-4437, Waldenburg, Switzerland)), which yielded 4-mm-diameter bone specimens, was used to obtain sternal biopsies through a small skin incision. Sections (7 microm) of the bone specimens wer...
Effects of analgesia of the distal interphalangeal joint or palmar digital nerves on lameness caused by solar pain in horses. To determine if pain of the dorsal margin of the sole in horses can be attenuated by anesthesia of either the distal interphalangeal (DIP) joint or the palmar digital (PD) nerves. Methods: A unilateral forelimb lameness was induced by creating solar pain. Response to administration of local anesthetic or saline solution into the DIP joint and to administration of local anesthetic around the PD nerves was evaluated. Methods: Six horses. Methods: Lameness was induced by creating pressure on the dorsal margin of the sole by screwing set-screws into a nut welded to the inside of each branch of a s...
Modes of local drug delivery to the musculoskeletal system. A number of methods for the local delivery of drugs to musculoskeletal tissues in the horse are now available. Further research is required to document the disposition of drugs delivered by such methods and to correlate this information with efficacy. Perhaps the greatest potential area for the methods discussed is the treatment of synovial and bone infections. To be able to provide high and sustained therapeutic concentrations of antimicrobials to the site of infection should increase the chances of success in such cases. These methods of drug delivery need to be used in conjunction with othe...
Bupivacaine in the horse: relationship of local anaesthetic responses and urinary concentrations of 3-hydroxybupivacaine. Bupivacaine is a potent local anaesthetic used in equine medicine. It is also classified as a Class 2 foreign substance by the Association of Racing Commissioners International (ARCI). The identification of residues in postrace urine samples may cause regulators to impose significant penalties. Therefore, an analytical/pharmacological database was developed for this medication. The highest no-effect dose (HNED) for the local anaesthetic effect of bupivacaine was determined to be 0.25 mg by using an abaxial sesamoid local anaesthetic model. Administration of the HNED of bupivacaine to eight hor...
Mepivacaine: its pharmacological effects and their relationship to analytical findings in the horse. Mepivacaine is a local anaesthetic drug that is widely used in equine medicine and is classified by the Association of Racing Commissioners International (ARCI) as a Class 2 foreign substance that may cause regulators to impose significant penalties if residues are identified in post-race urine samples. Therefore, an analytical/pharmacological database was developed for this agent and its metabolites. Using an abaxial sesamoid local anaesthetic model, it was determined that the highest no-effect dose (HNED) for its local anaesthetic effect was 2 mg. Using enzyme-linked immunosorbent assay (ELI...
Lack of local anaesthetic efficacy of fentanyl in the abaxial sesamoid block model. Fentanyl and other opioid drugs have their effect in the central nervous system; however, activity at peripheral sites has also been demonstrated. Pain-suppression activity at peripheral sites raises the possibility of skilled individuals producing local anaesthetic effects with small doses of opioid drugs that would be difficult to detect forensically and could be used to affect the outcome of a race. Therefore, the local pain-suppression effect (peripheral nerve inhibition) of fentanyl was tested using an abaxial sesamoid block/hoof withdrawal model. With this model, fentanyl did not produce...
Lidocaine in the horse: its pharmacological effects and their relationship to analytical findings. Lidocaine is a local anaesthetic agent that is widely used in equine medicine. It is also an Association of Racing Commissioners International (ARCI) Class 2 foreign substance that may cause regulators to impose substantial penalties if residues are identified in post race urine samples. Therefore, an analytical/pharmacological database was developed for this drug. Using our abaxial sesamoid local anaesthetic model, the highest no-effect dose (HNED) for the local anaesthetic effect of lidocaine was determined to be 4 mg. Using enzyme-linked immunosorbent assay (ELISA) screening, administration...
Standing laparoscopically-aided ovariectomy in mares. Bilateral ovariectomy was performed in 11 mares and unilateral ovariectomy in 2 mares. The horses were standing and sedated for surgery. After appropriate preparation a laparoscope was inserted into the abdomen through the paralumbar fossa and the ovary was identified and anaesthetised with local anaesthetic via a custom-built needle. The ovary was then withdrawn from the abdomen through a separate flank incision and removed. The abdomen was not distended with gas before surgery. This method proved to be minimally invasive, rapid and effective.
Laparoscopic cryptorchidectomy in standing horses. The purpose of this study was to determine the feasibility of using laparoscopy to remove cryptorchid testes from standing horses. Methods: Prospective clinical study. Methods: Eleven client-owned horses ranging in age from 4 months to 2 years. Methods: Abdominal insufflation was initiated and maintained using a 20 F insufflation tube, attached via a stopcock, to the low pressure regulator on a standard carbon dioxide pressure tank. After trocar and laparoscope placement in the ipsilateral flank the testes were identified. Local anesthesia of the structures to be manipulated was administered t...
Lack of local anaesthetic efficacy of Sarapin in the abaxial sesamoid block model. Sarapin is a distillate of the pitcher plant that has long been used in human and veterinary medicine for 'regional analgesia'. The mechanism of the reported analgesic response is unknown; however, the agent is purported to provide more effective analgesia for slow, chronic pain than for sharp, acute pain. Reportedly, Sarapin is also widely used as an analgesic agent in the horse, generally in combination with corticosteroids and other agents. To determine its local anaesthetic efficacy in the horse, we tested Sarapin in a unilateral abaxial sesamoid block model at two dose levels, 2 mL and 10...
Intra-articular anesthesia of the distal interphalangeal joint alleviates lameness associated with the navicular bursa in horses. To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Methods: Experimental investigation. Methods: Six clinically normal horses. Methods: Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings we...
Effects of anesthesia of the palmar digital nerves on kinematic gait analysis in horses with and without navicular disease. To determine the effect of local anesthesia of the palmar digital nerves on forelimb kinematics in Quarter Horses with and without navicular disease. Methods: 12 adult Quarter Horses; 5 clinically normal (sound) and 7 with navicular disease. Methods: Kinematic measurements were made on adult horses trotting on a treadmill, before and after palmar digital nerve block (PDNB). Twenty-three displacement, joint angle, and temporal gait measurements of the right forelimb and head were made for 5 strides in each horse. Initial (before local anesthesia) right forelimb measurements were obtained after ...
Anatomy of the distal interphalangeal joint of the mature horse: relationships with navicular suspensory ligaments, sensory nerves and neurovascular bundle. The anatomy of the distal interphalangeal (DIP) joint in the adult horse is described in relationship to the suspensory ligaments of the navicular bone, the neurovascular bundle and the sensory nerves to these periarticular regions. Using polymer plastic injections, the synovial cavity of the DIP joint was observed to have a complex relationship to the proximal suspensory or collateral sesamoidean ligament (CSL) of the navicular bone with the cavity forming cranial and caudal compartments around the CSL abaxially. Sensory nerves, as identified by peptide immunocytochemistry and silver/gold chl...
Radiological appearance of air introduced during equine regional limb anaesthesia. Twelve horses were injected intra-articularly into the metacarpophalangeal joint and extra-articularly in the region of the lateral palmar digital nerve with 1 ml air and local anaesthetic to simulate gas accidentally introduced during regional anaesthesia. Half the horses underwent limited exercise after which all horses were radiographed at 15 and 45 min and then every 24 h until all evidence of gas had disappeared. Intra-articular gas appeared as gas capped radiolucencies (GCR) in the proximal aspect of the joint. Extra-articular gas appeared as linear radiolucencies (LR) which initially te...
Local distribution of mepivacaine after distal interphalangeal joint injection in horses. To evaluate the distribution of mepivacaine hydrochloride after distal interphalangeal (DIP) joint injection in horses. Methods: Prospective, uncontrolled study. Methods: 10 adult horses. Methods: 30 minutes before euthanasia, 8 ml of 2% mepivacaine hydrochloride was injected into the dorsal pouch of a forelimb DIP joint. Synovial tissue from the DIP joint and podotrochlear (navicular) bursa and bone tissue from the medullary cavity of the distal sesamoid (navicular) bone were taken from both forelimbs immediately after death. All synovial and bone specimens were analyzed for tissue concentrat...
Regulatory significance of procaine residues in plasma and urine samples: preliminary communication. Plasma and urinary concentrations of procaine and the duration of response to procaine after its administration as a local anaesthetic to horses were studied. Following injection of a clinical dose of procaine HCl (80 mg), the concentration of procaine in plasma was less than the lower limit of quantitation and unsuitable for threshold determination. Therefore, the urinary concentration of procaine was determined after injection of a dose of 5 mg procaine HCl, the highest no-effect dose (HNED) of this agent. Free unconjugated procaine in equine urine reached a peak concentration of 23.7 ng/mL,...
Surgical treatment of navicular syndrome in the horse using navicular suspensory desmotomy. Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.
Determination of highest no effect dose (HNED) for local anaesthetic responses to procaine, cocaine, bupivacaine and benzocaine. The highest no effect doses (HNEDs) for the local anaesthetic (LA) effects of procaine, cocaine, bupivacaine and benzocaine were determined using the heat lamp/hoof withdrawal model of Kamerling et al. (1985b) and the abaxial sesamoid block model of local anaesthesia. The heat lamp rapidly (4 or 5 s) increased the temperature of the superficial skin layers of the pastern to about 90 degrees C, at which point the animal sharply withdrew its hoof. Effective LA blockade precluded this response and superficial skin temperatures exceeded 120 degrees C. Thermal stimulus experiments were routinely te...
The diagnostic nerve block of the sesamoidean nerve: desensitized structures and possible clinical applications. The sesamoidean nerve branches from the palmar nerve and runs towards the proximal sesamoid bone. To study the structures innervated by this nerve, a technique for blocking it was developed. The effect of this nerve block was determined in ponies with an induced lameness located in the lateral proximal sesamoid bone (5 ponies) or in the distal part of the lateral branch of the suspensory ligament (5 ponies), and in 10 horses with clinical sesamoidosis. A lameness provoked by the implantation of an expansion plug in the proximal sesamoid bone could, to a large extent, be anaesthetized by a sesa...
Bilateral lameness in horses–a kinematic study. The kinematic pattern of mild bilateral lameness was studied by inducing a supporting limb lameness in both fore-limbs of 11 sound Dutch Warmblood horses. The kinematics of the horses were recorded while they trotted (3.5 m/s) on a treadmill. The locomotion analysis system CODA-3 was used to determine the temporal stride patterns, limb movements as well as head and trunk movement patterns. The transient lameness model, by which pressure-induced pain is evoked on the hoof sole, was used. Differences between left and right limbs as well as between the sound and the lame condition were tested usi...
Permanent tracheostomy in standing horses: technique and results. Permanent tracheal stomas were created in seven sedated, standing horses with severe upper airway obstruction. After local anesthesia, a 3-cm by 6-cm rectangle of skin was removed from the ventral surface of the neck, 3 cm distal to the cricoid cartilage. The sternothyrohyoideus muscles were clamped proximally and distally, then transected to expose the tracheal rings. The ventral third of four tracheal rings was dissected from the tracheal mucosa that was then incised in a double "Y." Two layers of suture were used to achieve mucocutaneous closure. Stomas healed without serious complications;...
Sensory innervation of the navicular bone and bursa in the foal. The sensory innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments [ligamenta sesamoidea collateralia (CSL) and ligamentum sesamoideum distale impar or distal sesamoidean impar (DS-impar) ligament] and the navicular bursa (podotrochlearis) was examined in the neonatal foal using immunocytochemistry. With antisera raised to substance P (SP) and human calcitonin gene-related peptide (CGRP), immunoreactive nerves were demonstrated to innervate the CSL and navicular bursa. Within CSL, and SP- and CGRP-like nerves were present in the synovial lining of the navicular...
The effect of reversible left recurrent laryngeal neuropathy on the metabolic cost of locomotion and peak aerobic power in thoroughbred racehorses. The effect of left recurrent laryngeal neuropathy (LRLN) on the metabolic cost of locomotion (MCL) and peak aerobic power (VO2peak) was evaluated in four trained Thoroughbred racehorses. Oxygen consumption (VO2), carbon dioxide production (VCO2), venous lactate concentrations (LAC), and heart rate (HR) were measured during a treadmill exercise test (TET). Each horse performed the exercise test four times, alternating between normal upper airway function and reversibly induced LRLN. Subcutaneous infusion of 2% mepivicaine, a local anesthetic, into the region were the left recurrent laryngeal ne...
A silver-impregnation and immunocytochemical study of innervation of the distal sesamoid bone and its suspensory ligaments in the horse. The innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments (ligamenta sesamoidea collateralia) (CSL) or proximal suspensory ligament and the ligamentum sesamoideum distale impar or the distal sesamoidean impar ligament (DS-impar ligament) was examined using combined anatomical techniques of silver impregnation and immunocytochemistry. Silver impregnation studies revealed an abundance of nerve fibres present in both the CSL and DS-impar ligament with the latter having relatively more nerve fibres. These silver-impregnated nerves coursed parallel to and were asso...
Proximal suspensory desmitis in the hindlimb: 42 cases. Proximal suspensory desmitis of the hindlimb was diagnosed using local analgesic techniques and ultrasonography in 42 horses. Subtarsal analgesia resulted in substantial improvement in lameness in 36 of 41 horses in which local analgesic techniques were used. In the remaining five horses lameness was improved by perineural analgesia of the tibial nerve (three) or the tibial and fibular nerves. Intra-articular analgesia of the tarso-metatarsal joint produced a similar degree of improvement in two of 24 horses in which lameness had been improved by subtarsal analgesia. Ultrasonographic abnormali...
Pharmacokinetic values of drugs frequently used in performance horses. Tables of values of pharmacokinetic variables (volume of distribution, total body clearance, and plasma elimination half-life) of drugs frequently administered to performance horses are accompanied by explanatory notes. Drugs described include the nonsteroidal anti-inflammatory drugs, corticosteroids, anabolic steroids, central nervous system-modifying drugs, respiratory system drugs, diuretics, local anesthetics, and antibacterial drugs.
