Duration of action of mepivacaine and lidocaine in equine palmar digital perineural blocks in an experimental lameness model.
Abstract: To establish and compare the onset and duration of action of 2 local anesthetics based on objective lameness and skin sensitivity assessment. Methods: Interventional crossover experimental trial with balanced randomization. Methods: Eight horses. Methods: Reversible forelimb lameness was induced in 8 horses. A palmar digital nerve block (PDNB) was applied with mepivacaine or lidocaine (both 2%). Quantitative lameness and skin sensitivity data were collected with an inertial sensor system and a force gauge, respectively. The times to lameness resolution/skin desensitization (T1), consistent lameness detection/partial return of skin sensitivity (T2), and complete return of lameness/skin sensitivity (T3) were determined and compared between treatments and assessment methods. Results: Mepivacaine blocks resolved lameness in 8/8 horses, compared to 3/8 horses with lidocaine blocks. Both agents led to skin desensitization in 8/8 horses. Skin desensitization occurred sooner than lameness resolution after mepivacaine (P = .047). Duration of action was longer with mepivacaine than lidocaine (mean T3_lameness mepivacaine 366 minutes, lidocaine 113 minutes (P = .038); T3_skin mepivacaine 195 minutes, lidocaine 63 minutes [P ≤ .001]). Skin sensitivity returned sooner than lameness after lidocaine block at T3 (P = .015). Conclusions: The use of lidocaine in PDNBs for the purpose of lameness diagnosis should be reassessed, as it may not resolve lameness despite loss of skin sensation. Mepivacaine is superior, with a reliable onset and longer duration of action. Skin desensitization as an indicator for the onset of action or effectiveness of PDNBs for mepivacaine and lidocaine, or as a measure of the duration of action of lidocaine PDNBs should be interpreted with caution.
© 2017 The American College of Veterinary Surgeons.
Publication Date: 2017-07-13 PubMed ID: 28703891DOI: 10.1111/vsu.12689Google Scholar: Lookup
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- Journal Article
Summary
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The research explores and compares the effectiveness and time span of local anesthetics mepivacaine and lidocaine in treating lameness in horses. It is found that mepivacaine is more reliable, having a longer duration of effect and fully addressing lameness.
Methods
- The research implemented an interventional crossover experimental trial. They used a balanced randomization setup on eight horses.
- The researchers artificially induced mild lameness in the horse’s forelimb, to create an experimental lameness model. This condition was then addressed with a palmar digital nerve block (PDNB) administered either through mepivacaine or lidocaine, both at 2% concentrations.
- Data on lameness quantification and skin sensitivity were collected with the help of an inertial sensor system and force gauge respectively.
- The study considered three time phases: T1 (the time for lameness resolution/skin desensitization), T2 (consistent lameness detection/partial return of skin sensitivity), and T3 (complete return of lameness/skin sensitivity). The comparison drawn between treatments and assessment methods were based on this data.
Results
- All horses treated with mepivacaine evidenced resolution of lameness while only 3/8 horses showed improvement with lidocaine.
- All horses showed skin desensitization, regardless of the anesthetic used. However, skin desensitization took place earlier than lameness resolution in the case of mepivacaine.
- Mepivacaine displayed greater duration, with an average of 366 minutes to complete lameness return, and 195 minutes for overall skin sensitivity recovery. Lidocaine lasted just an average of 113 minutes and 63 minutes for complete lameness and skin sensitivity return respectively.
- After application of the lidocaine block, skin sensitivity returned sooner than lameness recovery.
Conclusions
- The research advises a reassessment of the use of lidocaine in PDNBs for diagnosing lameness, given its failure to completely resolve lameness contrasted with a loss of skin sensation.
- The study concludes mepivacaine to be a superior choice, providing a reliable onset and longer duration of action.
- Cautions are recommended while interpreting skin desensitization as an indicator for the onset of action or effectiveness of PDNBs for both mepivacaine and lidocaine, as well as for measuring the duration of action of lidocaine PDNBs.
Cite This Article
APA
Hoerdemann M, Smith RL, Hosgood G.
(2017).
Duration of action of mepivacaine and lidocaine in equine palmar digital perineural blocks in an experimental lameness model.
Vet Surg, 46(7), 986-993.
https://doi.org/10.1111/vsu.12689 Publication
Researcher Affiliations
- Equine Department, College of Veterinary Medicine, Murdoch University, Perth, Australia.
- Equine Department, College of Veterinary Medicine, Murdoch University, Perth, Australia.
- Small Animal Surgery Department, College of Veterinary Medicine, Murdoch University, Perth, Australia.
MeSH Terms
- Anesthetics, Local / administration & dosage
- Anesthetics, Local / pharmacology
- Animals
- Female
- Gait
- Horse Diseases / diagnosis
- Horse Diseases / physiopathology
- Horse Diseases / therapy
- Horses
- Lameness, Animal / drug therapy
- Lidocaine / administration & dosage
- Lidocaine / pharmacology
- Male
- Mepivacaine / administration & dosage
- Mepivacaine / pharmacology
- Nerve Block / methods
- Nerve Block / veterinary
- Pilot Projects
Citations
This article has been cited 8 times.- Fu W, Hu X, Li G, Liu S. MicroRNA-27a Suppresses the Toxic Action of Mepivacaine on Breast Cancer Cells via Inositol-Requiring Enzyme 1-TNF Receptor-Associated Factor 2. Contrast Media Mol Imaging 2023;2023:1153034.
- Zaha C, Schuszler L, Dascalu R, Nistor P, Florea T, Imre K, Rujescu C, Sicoe B, Igna C. Evaluation of Thermal Changes of the Sole Surface in Horses with Palmar Foot Pain: A Pilot Study. Biology (Basel) 2023 Mar 10;12(3).
- Maldonado MD, Parkinson SD, Story MR, Haussler KK. The Effect of Chiropractic Treatment on Limb Lameness and Concurrent Axial Skeleton Pain and Dysfunction in Horses. Animals (Basel) 2022 Oct 19;12(20).
- Cota LO, Malacarne BD, Dias LA, Neto ACP, Kneipp MLA, Cavalcante MA, Cunha MSLD, Paz CFR, Carvalho AM, Faleiros RR, Xavier ABDS. Mechanical nociceptive assessment of the equine hoof after navicular bursa anesthetic infiltration validated by bursography. PLoS One 2022;17(6):e0269532.
- Bonilla AG, Causeret L, Torrent-Crosa A. Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses. Can Vet J 2021 Sep;62(9):975-981.
- Radtke A, Fortier LA, Regan S, Kraus S, Delco ML. Intra-articular anaesthesia of the equine stifle improves foot lameness. Equine Vet J 2020 Mar;52(2):314-319.
- Ferlini Agne G, Adamson K, McGlinchey L, Kravchuk O, Santos L, Schumacher J. Comparison of a hand-held high-end resolution infrared thermography (FLIR P640) and a smartphone infrared thermographic device (FLIR One) for the assessment of skin surface temperature after anaesthetising the median nerve in Healthy horses. PLoS One 2024;19(8):e0309603.
- Gruyaert M, Oosterlinck M, Haspeslagh M, Nagy A. Computed tomographic evaluation of the proximity of needles placed for perineural anesthesia of the palmar digital nerves to synovial structures in the foot: an ex vivo study. Front Vet Sci 2024;11:1404331.
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