FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Vet Surg / Effects of subconjunctival ropivacaine, liposomal bupivacain...
Veterinary surgery : VS2023; doi: 10.1111/vsu.13980

Effects of subconjunctival ropivacaine, liposomal bupivacaine, and mepivacaine on corneal sensitivity in healthy horses.

Abstract: To evaluate corneal sensitivity and adverse events following subconjunctival administration of three local anesthetics in horses. Methods: Randomized, masked, crossover study. Methods: Twelve healthy adult mares. Methods: The subconjunctival space of the treated eye was injected with 0.2 mL of liposomal bupivacaine (1.3%), ropivacaine (0.5%), or mepivacaine (2%). All horses received each medication once and the contralateral eye received saline (control). Corneal touch threshold (CTT) was measured using a Cochet-Bonnet esthesiometer before sedation, after sedation, and at specified intervals until it returned to baseline. Ocular examinations were performed at 24-, 72, and 168 h post-injection to monitor for adverse effects. Results: The mean total time of anesthesia (TTA) was 168.3 min for ropivacaine, 169.2 min for liposomal bupivacaine, 103.3 min for mepivacaine and 30.7 min for the control. TTA for liposomal bupivacaine (p < .001) and ropivacaine (p = .001) was longer than the control. TTA for mepivacaine was not different from the control (p = .138), liposomal bupivacaine (p = .075) or ropivacaine (p = .150). Injection site hemorrhage reduced TTA regardless of treatments (p = .047). No adverse effects attributed to injections were noted. Conclusions: All three medications were well tolerated. Subconjunctival administration of ropivacaine and liposomal bupivacaine resulted in longer TTAs compared to the control; however, their TTAs were not different from that of mepivacaine. Conclusions: Subconjunctivally administered liposomal bupivacaine and ropivacaine are viable options to provide prolonged corneal analgesia in horses. Future studies are needed to assess the efficacy in diseased eyes.
© 2023 American College of Veterinary Surgeons.
Get Full Text
Publication Date: 2023-06-18 PubMed ID: 37332132DOI: 10.1111/vsu.13980Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

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.

This research study investigates the effects of three different local anesthetics on the corneal sensitivity of healthy horses, concluding that all were well-tolerated, with ropivacaine and liposomal bupivacaine offering longer periods of anesthesia compared to a saline control.

Research Methodology

  • The experimented involved a randomized, masked crossover study featuring 12 healthy adult mare horses.
  • Every one of these mares received an injection of 0.2mL of one of three local anesthetics – liposomal bupivacaine, ropivacaine, or mepivacaine – in the subconjunctival space of the treated eye.
  • The opposite eye (contra-lateral) of each horse received a saline injection, as a control variable.
  • A Cochet-Bonnet esthesiometer was used to measure the Corneal touch threshold (CTT). Measurements were made at distinct intervals – prior to sedation, post sedation, and continuing until the sensitivity returned to its original state.
  • Observations for any potential adverse effects were conducted at 24, 72, and 168 hours post injection.

Results

  • The mean total time of anesthesia (TTA) for each drug was recorded. Ropivacaine and liposomal bupivacaine displayed longer TTAs (168.3 and 169.2 minutes respectively) when compared to the control. Mepivacaine had a mean TTA of 103.3 minutes.
  • Statistical analysis revealed that TTA for ropivacaine and liposomal bupivacaine were significantly longer than the saline control. However, the TTA for mepivacaine was not significantly different from either the control or the other two anesthetics.
  • There was observation that hemorrhage at injection site generally reduced the TTA, regardless of the anesthetic used.

Conclusions

  • All three anesthetics were well-tolerated by the horses, with no identified adverse effects.
  • The TTA for ropivacaine and liposomal bupivacaine was significantly longer than the saline solution, suggesting they may provide prolonged corneal pain relief.
  • While the TTA for mepivacaine was not significantly different from either the other anesthetics or the control, it could still be considered as a viable option.
  • The study hints at liposomal bupivacaine and ropivacaine are promising for prolonged corneal analgesia in horses, but further research is needed to evaluate their efficacy on diseased eyes.

Cite This Article

APA
Gonzalez GA, Betbeze C, Wills R, Eddy A, Mochal-King C, Fontenot RL. (2023). Effects of subconjunctival ropivacaine, liposomal bupivacaine, and mepivacaine on corneal sensitivity in healthy horses. Vet Surg. https://doi.org/10.1111/vsu.13980

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Gonzalez, Gabriel A
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Betbeze, Caroline
  • Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Wills, Robert
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Eddy, Alison
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Mochal-King, Cathleen
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Fontenot, Robin L
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.

Grant Funding

  • G00006806 / American College of Veterinary Surgeons Foundation
  • 110000-182500-021000-CVM010 / Mississippi State University College of Veterinary Medicine Office of Research and Graduate Studies
  • Mississippi State University College of Veterinary Medicine Terri Nusz Endowment for Equine Surgery

References

This article includes 45 references
  1. Kalf KL, Utter ME, Wotman KL. Evaluation of duration of corneal anesthesia induced with ophthalmic 0.5% proparacaine hydrochloride by use of a Cochet-Bonnet aesthesiometer in clinically normal horses.. Am J Vet Res 2008;69(12):1655-1658.
    doi: 10.2460/ajvr.69.12.1655google scholar: lookup
  2. Sharrow-Reabe KL, Townsend WM. Effects of action of proparacaine and tetracaine topical ophthalmic formulations on corneal sensitivity in horses.. J Am Vet Med Assoc 2012;241(12):1645-1649.
    doi: 10.2460/javma.241.12.1645google scholar: lookup
  3. Pucket JD, Allbaugh RA, Rankin AJ, Ou Z, Bello NM. Comparison of efficacy and duration of effect on corneal sensitivity among anesthetic agents following ocular administration in clinically normal horses.. Am J Vet Res 2013;74(3):459-464.
    doi: 10.2460/ajvr.74.3.459google scholar: lookup
  4. Swaminathan A, Otterness K, Milne K, Rezaie S. The safety of topical anesthetics in the treatment of corneal abrasions: A review.. J Emerg Med 2015;49(5):810-815.
    doi: 10.1016/j.jemermed.2015.06.069google scholar: lookup
  5. Epstein DL, Paton D. Keratitis from misuse of corneal anesthetics.. N Engl J Med 1968;279(8):396-399.
    doi: 10.1056/nejm196808222790802google scholar: lookup
  6. Willis WE, Laibson PR. Corneal complications of topical anesthetic abuse.. Can J Ophthalmol 1970;5(3):239-243.
  7. Liu JC, Steinemann TL, McDonald MB, Thompson HW, Beuerman RW. Topical bupivacaine and proparacaine: A comparison of toxicity, onset of action, and duration of action.. Cornea 1993;12(3):228-232.
    doi: 10.1097/00003226-199305000-00008google scholar: lookup
  8. Sun R, Hamilton RC, Gimbel HV. Comparison of 4 topical anesthetic agents for effect and corneal toxicity in rabbits.. J Cataract Refract Surg 1999;25(9):1232-1236.
    doi: 10.1016/s0886-3350(99)00150-9google scholar: lookup
  9. Stevens JD. A new local anesthesia technique for cataract extraction by one quadrant sub-Tenon's infiltration.. Br J Ophthalmol 1992;76(11):670-674.
    doi: 10.1136/bjo.76.11.670google scholar: lookup
  10. Jinks MR, Fontenot RL, Wills RW, Betbeze CM. The effects of subconjunctival bupivacaine, lidocaine, and mepivacaine on corneal sensitivity in healthy horses.. Vet Ophthalmol 2018;21(5):498-506.
    doi: 10.1111/vop.12537google scholar: lookup
  11. Cummings IK, Chahar KC. Liposomal bupivacaine: A review of a new bupivacaine formulation.. J Pain Res 2012;5:257-264.
    doi: 10.2147/jpr.s27894google scholar: lookup
  12. Lascelles BDX, Kirkby SK. An extended release local anaesthetic: Potential for future use in veterinary surgical patients?. Vet Med Sci 2016;2(4):229-238.
    doi: 10.1002/vms3.43google scholar: lookup
  13. Puffer RC, Tou K, Winkel RE, Bydon M, Currier B, Freedman BA. Liposomal bupivacaine incisional injection in single-level lumbar spine surgery.. Spine J 2016;16(11):1305-1308.
    doi: 10.1016/j.spinee.2016.06.013google scholar: lookup
  14. McCracken MJ, Schumacher J, Doherty TJ, Sun X, Nichols CL, Olivarez J. Efficacy and duration of effect for liposomal bupivacaine when administered perineurally to the palmar digital nerves of horses.. Am J Vet Res 2020;81(5):400-405.
    doi: 10.2460/ajvr.81.5.400google scholar: lookup
  15. Knych HK, Mama KR, Moore CE, Hill AE, McKemie DS. Plasma and synovial fluid concentrations and cartilage toxicity of bupivacaine following intra-articular administration of a liposomal formulation to horses.. Equine Vet J 2019;51(3):408-414.
    doi: 10.1111/evj.13015google scholar: lookup
  16. Moorman VJ, Pezzanite LM, Griffenhagen GM. Liposomal bupivacaine provides longer duration analgesia than bupivacaine hydrochloride in an adjustable sole-pressure model of equine lameness.. Am J Vet Res 2022;83(4):298-304.
    doi: 10.2460/ajvr.21.08.0132google scholar: lookup
  17. Le KM, Caston SS, Hossetter JM, Hay Kraus BL. Comparison of analgesic and tissue effects of subcutaneous perineural injection of liposomal bupivacaine and bupivacaine hydrochloride in horses with forelimb lameness induced via circumferential clamp.. Am J Vet Res 2020;81(7):551-556.
    doi: 10.2460/ajvr.81.7.551google scholar: lookup
  18. Wienzek H, Freise H, Giesler I, Vanaken H, Sielenkaemper A. Altered blood flow in terminal vessels after local application of ropivacaine and prilocaine.. Reg Anesth Pain Med 2007;32(3):233-239.
    doi: 10.1016/j.rapm.2007.02.007google scholar: lookup
  19. Schumacher J, Boone L. Local anaesthetics for regional and intra-articular analgesia in the horse.. Equine Vet Educ 2021;33(3):159-168.
    doi: 10.1111/eve.13235google scholar: lookup
  20. Santos LCP, de Moraes AN, Saito ME. Effects of intraarticular ropivacaine and morphine on lipopolysaccharide-induced synovitis in horses.. Vet Anaesth Analg 2009;36(3):280-286.
    doi: 10.1111/j.1467-2995.2009.00452.xgoogle scholar: lookup
  21. Silva GB, de La Côrte FD, Brass KE. Duration and efficacy of different local anesthetics on the palmar digital nerve block in horses.. J Equine Vet Sci 2015;35(9):749-755.
    doi: 10.1016/j.jevs.2015.07.013google scholar: lookup
  22. Van Loon JPAM, Menke ES, Doornenbal A, Back W, Hellebrekers LJ. Antinociceptive effects of low dose lumbosacral epidural ropivacaine in healthy ponies.. Vet J 2012;193(1):240-245.
    doi: 10.1016/j.tvjl.2011.11.004google scholar: lookup
  23. . Mepivacaine hydrochloride [package insert].. 2019.
  24. Leawood K. Nocita (Bupivacaine Liposome Injectable Suspension).. 2016.
  25. . Ropivacaine HCl [package insert].. 2018.
  26. Brooks DE, Clark CK, Lester GD. Cochet-Bonnet aesthesiometer-determined corneal sensitivity in neonatal foals and adult horses.. Vet Ophthalmol 2000;3(2-3):133-137.
    doi: 10.1046/j.1463-5224.2000.00125.xgoogle scholar: lookup
  27. Kaps S, Richter M, Spiess BM. Corneal esthesiometry in the healthy horse.. Vet Ophthalmol 2003;6(2):151-155.
    doi: 10.1046/j.1463-5224.2003.00283.xgoogle scholar: lookup
  28. Faul F, Erdfelder E, Lang AG, Buchner A. G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.. Behav Res Methods 2007;39(2):175-191.
    doi: 10.3758/bf03193146google scholar: lookup
  29. Chao C, Stapleton F, Badaudin E, Golebiowski B. Ocular surface sensitivity repeatability with Cochet-Bonnet esthesiometer.. Optom Vis Sci 2015;92(2):183-189.
  30. Regnier A. Clinical pharmacology and therapeutics. Part 1: Drug delivery.. In: Gelatt K, Gilger B, Kern T, eds. Veterinary Ophthalmology. 5th ed. Wiley-Blackwell; 2013:351-380.
  31. Gelatt K, Ben-Shlomo G, Gilger B, Hendrix D, Kern T, Plummer C. Veterinary Opthamology. Vol 1.. 6th ed. John Wiley & Sons, Inc.; 2021.
  32. Conrad JM, Robinson JR. Mechanisms of anterior segment absorption of pilocarpine following subconjunctival injection in albino rabbits.. J Pharm Sci 1980;69(8):875-884.
    doi: 10.1002/jps.2600690806google scholar: lookup
  33. Costa D, Pena MT, Rios J, Leiva M. Evaluation of corneal anesthesia after the application of topical 2 per cent lidocaine, 0.5 per cent bupivacaine and 1 per cent ropivacaine in dogs.. Vet Rec 2014;174(19):478.
  34. Knoll-Köhler E, Förtsch G. Pulpal anesthesia dependent on epinephrine dose in 2% lidocaine.. Oral Surg Oral Med Oral Pathol 1992;73(5):537-540.
    doi: 10.1016/0030-4220(92)90091-4google scholar: lookup
  35. Nwosu S, Anajekwu C, Nwosu V, Ezenwa A. Retrobulbar versus subconjunctival anesthesia for cataract surgery.. Niger J Clin Pract 2011;14(3):280-283.
    doi: 10.4103/1119-3077.86767google scholar: lookup
  36. Kongsap P. Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: A randomized controlled trial.. Clin Ophthalmol 2012;6:1981-1986.
    doi: 10.2147/opth.s38606google scholar: lookup
  37. Abu-Mostafa N, Al-Showaikhat F, Al-Shubbar F, Al-Zawad K, Al-Zawad F. Hemodynamic changes following injection of local anesthetics with different concentrations of epinephrine during simple tooth extraction: a prospective randomized clinical trial.. J Clin Exp Dent 2015;7:e471-e476.
    doi: 10.4317/jced.52321google scholar: lookup
  38. Massaro F. Liposomal bupivacaine: A long acting local anesthetic for postsurgical analgesia.. Formulary 2012;47:212-226.
  39. Henkes HE, Waubke TN. Keratitis from abuse of corneal anaesthetics.. Br J Ophthalmol 1978;62(1):62-65.
  40. Dorbandt DM, Labelle AL, Mitchell MA, Hamor RE. The effects of topical diclofenac, topical flurbiprofen, and humidity on corneal sensitivity in normal dogs.. Vet Ophthalmol 2017;20(2):160-170.
    doi: 10.1111/vop.12386google scholar: lookup
  41. Ebrahimzadeh PR, Kubat J. Mechanosorptive effects in cellophane, polyamide 6 and some other polymers studied by dynamic mechanical analysis.. J Mater Sci 1997;32(16):4227-4235.
    doi: 10.1023/a:1018643016698google scholar: lookup
  42. Werner MU, Rotboll-Nielsen P, Ellehuus-Hilmersson C. Humidity affects the performance of von Frey monofilaments.. Acta Anaesthesiol Scand 2011;55(5):577-582.
  43. Mirzajani A, Jafarzadehpur E, Karimian F, Khezri F. Is corneal sensitivity sex dependent?. J Ophthalmic Vis Res 2015;10(2):102-105.
    doi: 10.4103/2008-322x.163772google scholar: lookup
  44. Andrade ES, Vieira JV, Gomes Júnior DC, Raposo ACS, Galera PD, Oriá AP. Corneal sensitivity in five horse breeds.. Ciência Rural 2017;47(6):1-6.
    doi: 10.1590/0103-8478cr20160995google scholar: lookup
  45. Tsuchiya H. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite.. J Inflamm Res 2008;1:41-48.
    doi: 10.2147/jir.s3982google scholar: lookup

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.