Duration of skin desensitisation following palmar digital nerve blocks with lidocaine, bupivacaine, mepivacaine and prilocaine.
Abstract: Objective comparative evidence of the time to onset and duration of effect provided by local anaesthetic (LA) agents for perineural blocks in the horse is lacking. Clear knowledge of these properties is required to guide clinically appropriate agent selection and aid interpretation of response to diagnostic blocks for lameness examinations. An interventional study, with complete, randomised crossover design was used to compare time to onset and duration of skin desensitisation provided by four LA agents applied to palmar digital nerve blocks in 12 horses. Effect at each time point was determined using a pressure gauge to measure the mechanical nociceptive threshold (MNT) over the heel bulbs. Complete desensitisation was defined when MNT was greater than four times the pre-block baseline. Onset and duration of complete desensitisation were recorded and compared across agents using a mixed linear model. When significant (P ≤ 0.05), post-hoc paired comparisons between agents were performed against a Tukey's corrected P ≤ 0.05. Onset of complete skin desensitisation for each agent was <5 min. Duration for lidocaine (mean 25 min; 95% confidence interval [CI] 9-42) was shorter than bupivacaine (53 min; 95% CI 39-65), which was shorter than both prilocaine (102 min; 95% CI 81-123) and mepivacaine (107 min; 95% CI 92-121), which were not different. Although onset of complete skin desensitisation was not different for the LA agents tested, duration varied from 25 min to nearly 2 h. Prilocaine and mepivacaine provided the most prolonged duration of effect, both exceeding bupivacaine.
© 2021 Australian Veterinary Association.
Publication Date: 2021-09-26 PubMed ID: 34569052DOI: 10.1111/avj.13122Google Scholar: Lookup
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- Journal Article
Summary
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The research is focused on understanding the duration and onset of skin desensitization after administering local anesthetics (lidocaine, bupivacaine, mepivacaine, and prilocaine) for nerve blocks in horses. The study objectives were met by measuring the mechanical nociceptive threshold on the heel bulbs of horses at different time frames post anesthesia to analyze and compare the agents’ effectiveness.
Research Methodology
- For this study, an interventional study design with randomised crossover was chosen. The experiment involved applying four different local anesthetic agents to palmar digital nerve blocks in 12 horses.
- The effect was measured at different time points using a pressure gauge to determine the mechanical nociceptive threshold over the horse’s heel bulbs.
- Complete desensitisation was defined when the mechanical nociceptive threshold was more than four times the pre-block baseline.
- The researchers recorded onset and duration of complete desensitisation and carried out comparison across the four agents using a mixed linear model.
- If the results were significant, further comparisons were carried out using Tukey’s method for significance correction.
Research Findings
- The onset of complete skin desensitisation for all agents tested was less than 5 minutes.
- The duration for lidocaine was found to be the shortest, with a mean of 25 minutes. This was followed by bupivacaine with a duration of 53 minutes.
- Prilocaine and mepivacaine resulted in the longest effect, with similar durations of 102 minutes and 107 minutes respectively. These two agents provided a significantly longer period of desensitisation than both lidocaine and bupivacaine.
- The results indicate that although the onset of complete skin desensitisation was similar across all local anesthetics tested, the duration of the effect varied, ranging from 25 minutes to nearly 2 hours.
Conclusion
- This research helps reveal the varying performance of common anesthetics in horses. Such information can guide veterinarians in choosing the most appropriate anesthesia, depending on the required duration of effect, which can potentially improve the care provided in lameness examinations and treatments.
Cite This Article
APA
Harcourt MM, Smith RL, Hosgood G.
(2021).
Duration of skin desensitisation following palmar digital nerve blocks with lidocaine, bupivacaine, mepivacaine and prilocaine.
Aust Vet J, 99(12), 541-546.
https://doi.org/10.1111/avj.13122 Publication
Researcher Affiliations
- Equine Department, College of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
- Equine Department, College of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
- Small Animal Surgery Department, College of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
MeSH Terms
- Anesthetics, Local / adverse effects
- Animals
- Bupivacaine
- Horses
- Lidocaine / adverse effects
- Mepivacaine
- Nerve Block / veterinary
- Prilocaine
Grant Funding
- Murdoch University
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