Continuous peripheral neural blockade to alleviate signs of experimentally induced severe forelimb pain in horses.
Abstract: To investigate the efficacy and safety of a low-volume, single-catheter, continuous peripheral neural blockade (CPNB) technique to locally deliver bupivacaine to alleviate signs of severe forelimb pain resulting from experimentally induced tendonitis in horses. Methods: Randomized controlled experimental trial. Methods: 14 horses and 5 forelimbs from equine cadavers. Methods: Horses underwent collagenase-induced superficial digital flexor tendonitis in the midmetacarpal region of 1 forelimb. To deliver analgesia, a closed-tip catheter was placed from lateral to medial, approximately 12 cm distal to the accessory carpal bone, between the suspensory ligament and accessory ligament of the deep digital flexor tendon. Success of catheter placement and anesthetic delivery was documented ex vivo in 5 forelimbs from equine cadavers. Effective analgesia in affected forelimbs of horses from continuous (n = 7) versus intermittent (7) local anesthetic delivery (intermittent peripheral neural blockade; IPNB) was compared over a 3-day period. Results: Horses that received CPNB in the affected forelimb were less lame than horses that received IPNB. A lower proportion of CPNB-treated horses had behavioral and physiologic signs of pain, compared with IPNB-treated horses. Neither technique completely blocked the sensation of pain or resulted in swelling in the distal portion of the forelimb, vasodilation, or an increase in lameness. After removal, Staphylococcus aureus was cultured from 1 catheter tip. Conclusions: For short-term treatment, CPNB was more effective than IPNB for reduction in signs of severe pain in the distal aspect of the forelimb of horses.
Publication Date: 2011-04-16 PubMed ID: 21492047PubMed Central: PMC11005056DOI: 10.2460/javma.238.8.1032Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This study aims to explore the effectiveness and safety of using continuous peripheral neural blockade (CPNB) technique in reducing extreme forelimb pain caused by tendonitis in horses, where the pain relief medicine, bupivacaine, is applied directly on the impacted area. The findings indicate that CPNB is more effective than intermittent peripheral neural blockade (IPNB) in reducing pain symptoms in the short-term, although neither completely alleviates pain.
Methods
- The researchers used a randomized controlled experimental trial featuring 14 horses as well as 5 forelimbs from equine cadavers.
- Tendonitis was experimentally induced in the horses using collagenase (an enzyme that breaks down collagen) in the superficial digital flexor tendon located in the midmetacarpal region of 1 forelimb.
- For pain relief, a closed-tip catheter was inserted from the lateral to medial, roughly 12 cm below the accessory carpal bone, between the suspensory ligament and the accessory ligament of the deep digital flexor tendon. This was followed by administration of the anesthetic, bupivacaine.
- The researchers performed an ex vivo examination on five forelimbs from deceased horses to verify the efficiency of the catheter placement and anesthetic caliber.
- Two groups of horses were studied for a period of 3 days – one that received continuous local anesthetic delivery (CPNB), and one that received intermittent anesthetic delivery (IPNB).
Results
- The horses in the continuous delivery group (CPNB) showed less lameness than those in the intermittent delivery group (IPNB).
- Horses treated with CPNB also exhibited fewer behavioral and physiological signs of pain compared to those treated with IPNB.
- However, neither technique could successfully block all pain sensations nor caused swelling in the distal portion of the forelimb, vasodilation, or an increase in lameness.
- Upon removal of the catheter, the bacteria Staphylococcus aureus was found in one catheter tip.
Conclusion
- Based on the findings, CPNB appears to be more effective than IPNB when it comes to short-term reduction of severe pain in the forelimbs of horses suffering from tendonitis.
- However, more research is needed to ensure complete alleviation of pain and to monitor potential infection risks from the procedure.
Cite This Article
APA
Watts AE, Nixon AJ, Reesink HL, Cheetham J, Fubini SL, Looney AL.
(2011).
Continuous peripheral neural blockade to alleviate signs of experimentally induced severe forelimb pain in horses.
J Am Vet Med Assoc, 238(8), 1032-1039.
https://doi.org/10.2460/javma.238.8.1032 Publication
Researcher Affiliations
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA. aew44@cornell.edu
MeSH Terms
- Anesthetics, Local / administration & dosage
- Anesthetics, Local / pharmacology
- Animals
- Bupivacaine / administration & dosage
- Bupivacaine / pharmacology
- Collagenases
- Horse Diseases / drug therapy
- Horses
- Nerve Block / methods
- Nerve Block / veterinary
- Pain / veterinary
- Tendinopathy / chemically induced
- Tendinopathy / drug therapy
- Tendinopathy / veterinary
Grant Funding
- T32 OD011000 / NIH HHS
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Citations
This article has been cited 1 times.- Royal JM, Settle TL, Bodo M, Lombardini E, Kent ML, Upp J, Rothwell SW. Assessment of postoperative analgesia after application of ultrasound-guided regional anesthesia for surgery in a swine femoral fracture model. J Am Assoc Lab Anim Sci 2013;52(3):265-76.
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