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Frontiers in veterinary science2020; 7; 232; doi: 10.3389/fvets.2020.00232

Cervical Epidural and Subarachnoid Catheter Placement in Standing Adult Horses.

Abstract: Horses underwent either cervical epidural space (CES) catheterization or subarachnoid space (SAS) catheterization while restrained in stocks, under deep sedation (detomidine and morphine) and local anesthesia (mepivacaine 2%) block. Catheters were placed under ultrasound guidance with visualization of the dura, SAS, and spinal cord between the first (C1) and second (C2) cervical vertebrae. Following sedation and sterile skin preparation, operator 1 placed under ultrasound guidance, a 6- or 8-inch Tuohy needle with the bevel oriented caudally. For CES, a 6-inch Touhy needle was used with the hanging drop technique to detect negative pressure, and operator 2 then passed the epidural catheter into the CES. For SAS, following puncture of the dura, cerebrospinal fluid (CSF) was aspirated prior to placement of the epidural catheter. Placement into either CES or SAS was confirmed with plain and contrast radiography. Catheters were wrapped for the duration of the study. CSF cytology was assessed up to every 24 h for the study period. Horses were assessed daily for signs of discomfort, neck pain, catheter insertion site swelling, or changes in behavior. A complete postmortem assessment of the spinal tissues was performed at the end of the study period (72 h). Two horses had CES catheters and five horses had SAS catheters placed successfully. All horses tolerated the catheter well for the duration of the study with no signs of discomfort. Ultrasound was essential to assist placement, and radiography confirmed the anatomical location of the catheters. CSF parameters did not change over the study period ( > 0.9). There was evidence of mild meningeal acute inflammation in one horse and hemorrhage in another consistent with mechanical trauma. Placement of an indwelling CES or SAS catheter appears to be safe, technically simple, and well tolerated in standing sedated normal horses.
Copyright © 2020 Hurcombe, Morris, VanderBroek, Habecker, Wulster and Hopster.
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Publication Date: 2020-05-14 PubMed ID: 32478105PubMed Central: PMC7239991DOI: 10.3389/fvets.2020.00232Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research reports a procedure aiming to place cervical epidural space (CES) or subarachnoid space (SAS) catheters in standing horses using ultrasound guidance, with an assessment of the effect of the catheter placement on the horse’s comfort and behavior.

Introduction and Methodology

  • The study was performed on adult equine subjects that were either subject to CES or SAS catheterization. The operations took place while the horses were standing and deeply sedated with detomidine and morphine. Local anesthesia was also provided with a 2% solution of mepivacaine.
  • The catheter placements were performed using ultrasound imaging as a guide, with the goal of visualizing the dura mater, SAS, and the spinal cord existing between the C1 and C2 cervical vertebrae.
  • For the CES operation, a 6-inch Touhy needle was used, while for SAS operation, an 8-inch needle was used. For each operation, a secondary operator would pass the epidural catheter into the appropriate space (CES or SAS) after the first operator established it with the needle.

Catheter Placement and Assessments

  • After the puncture to the dura matter for SAS catheterization, cerebrospinal fluid(CSF) was extracted before the placement of the epidural catheter.
  • The placements were then confirmed using both plain and contrast radiography.
  • The catheters were covered and remained in place for 72 hours while daily assessments were conducted to observe any discomfort, neck pain, swelling, or behavioural changes in the horses.
  • Cytological assessment of the CSF was also performed on a daily basis.

Results

  • The research successfully placed CES catheters in two horses and SAS catheters in five horses.
  • All the subjects were reported to have tolerated the apparatus well and did not show any signs of discomfort within the study period.
  • The utility of the ultrasound was emphasized as it greatly assisted the placement process and the radiography confirmed the accurate anatomical positioning of the catheters.
  • The research found that the CSF parameters remained unaffected by the surgery and catheter placement throughout the study with a P-value greater than 0.9.
  • A few minor complications were observed at the end of the study: one horse exhibited mild meningeal acute inflammation and another one showed signs of hemorrhage which is consistent with mechanical trauma

From the results, it can be concluded that the procedure of inserting a CES or SAS catheter in standing, sedated horses is safe and technically simple, and it doesn’t cause any noticeable discomfort.

Cite This Article

APA
Hurcombe SD, Morris TB, VanderBroek AR, Habecker P, Wulster K, Hopster K. (2020). Cervical Epidural and Subarachnoid Catheter Placement in Standing Adult Horses. Front Vet Sci, 7, 232. https://doi.org/10.3389/fvets.2020.00232

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 7
Pages: 232
PII: 232

Researcher Affiliations

Hurcombe, Samuel D
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
Morris, Tate B
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
VanderBroek, Ashley R
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
Habecker, Perry
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
Wulster, Kathryn
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
Hopster, Klaus
  • Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.

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Citations

This article has been cited 4 times.
  1. Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K. Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes. Front Vet Sci 2022;9:995299.
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  2. Guo Q, Li R, Zhou W, Li X. Image Segmentation-Based Cervical Spine MRI Images to Evaluate the Treatment of Patients with Chronic Pain. Comput Math Methods Med 2022;2022:2648659.
    doi: 10.1155/2022/2648659pubmed: 35799646google scholar: lookup
  3. Johnson JP, Vinardell T, David F. Ultrasound-guided injections of the equine head and neck: review and expert opinion. J Equine Sci 2021 Dec;32(4):103-115.
    doi: 10.1294/jes.32.103pubmed: 35023988google scholar: lookup
  4. Watkins AR, Hopster K, Levine D, Hurcombe SD. Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report. Front Vet Sci 2021;8:749713.
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