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Equine veterinary journal2018; 50(6); 733-738; doi: 10.1111/evj.12947

Local mepivacaine before castration of horses under medetomidine isoflurane balanced anaesthesia is effective to reduce perioperative nociception and cytokine release.

Abstract: In horses castration with primary intention healing is usually performed under balanced inhalation anaesthesia. To optimise analgesia, the use of local anaesthesia was tested. Objective: To investigate the effect of local mepivacaine before castration with first intention healing under balanced medetomidine-isoflurane anaesthesia and flunixin meglumine, morphine analgesia on perioperative cytokine levels and pain in horses. Methods: Prospective blinded clinical study. Methods: Twenty stallions were randomly assigned to control or mepivacaine groups. Flunixin meglumine was administered before sedation with medetomidine and followed by ketamine/diazepam intravenously (i.v.). Anaesthesia was maintained with isoflurane and 3.5 μg/kg per hour medetomidine. Mepivacaine horses were given mepivacaine 2% (3.5 mL SC, 1 mL/100 kg intrafunicularly, 2 mL/100 kg intratesticularly) on each side. For recovery, horses were given 2 μg/kg medetomidine i.v. and 0.1 mg/kg morphine i.m. and oral phenylbutazone (0.02 mg/kg q12h) for post-operative analgesia. One hour before premedication and 4, 8 and 24 h post-incision, pain was scored with three different pain scales (Equine Utrecht University Scale for Facial Assessment of Pain, Horse Grimace Scale, Equine Utrecht University Scale for Composite Pain Assessment) and plasma cytokines (interleukin-6 and tumour necrosis factor alpha) were measured. Data were analysed using repeated measures ANOVA, linear regression and unpaired t-test, significance level P≤0.05. Results: Horses in both groups showed a significant increase in pain scores and cytokines compared to baseline. Post-operatively the mepivacaine group exhibited significantly lower pain scores and cytokine levels. Mean heart rate during anaesthesia was significantly lower in the mepivacaine group compared to control group (28.8 ± 1 and 33.2 ± 1.7 respectively). Otherwise there were no differences between the groups. Conclusions: The decision to provide additional analgesia was based on the attending surgeon's assessment rather than a standardised rescue analgesia plan based on pain scores. The study was only conducted for 24 h post-castration and complications were not recorded. Conclusions: Local mepivacaine before castration with primary wound closure improved anaesthesia quality, attenuated post-operative increases in cytokines and reduced post-operative pain despite balanced anaesthesia with multimodal analgesia in control horses.
© 2018 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2018-05-16 PubMed ID: 29660154PubMed Central: PMC6175468DOI: 10.1111/evj.12947Google Scholar: Lookup
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  • Clinical Trial
  • Veterinary
  • 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 investigates the effects of the local application of an anesthetic called mepivacaine prior to the castration of horses. The results indicate that using mepivacaine helps to reduce both pain and cytokine levels during and after the procedure.

Research Background and Objectives

  • The research article is based on a study conducted on horses undergoing castration under a particular type of anaesthesia known as balanced inhalation anaesthesia.
  • The main objective of the study was to investigate the effect of applying a local anaesthetic, mepivacaine, before the surgery on pain levels and cytokines during and after the procedure.

Research Methods

  • The researchers conducted a clinical study involving 20 stallions, grouped into control and mepivacaine groups.
  • Before the surgery, the horses were sedated and later given an intravenously administered anaesthetic combo of ketamine/diazepam.
  • The horses in the mepivacaine group were given the anaesthetic on both sides of their testes, and all horses were given pain relief medication after the operation.
  • Pain levels were regularly checked using three different pain scales, and plasma cytokines were measured at set intervals following the incision.
  • Statistical methods used to analyse the data included repeated measures ANOVA, linear regression, and an unpaired t-test.

Research Findings

  • Both groups of horses, those who had been given local mepivacaine, and those who had not, showed increased pain scores and cytokine levels after the procedure.
  • However, horses that had been administered with mepivacaine exhibited considerably lower pain scores and cytokine levels post-operatively.
  • The heart rate during anaesthesia was also found to be significantly lower in the mepivacaine group compared to the control group.

Study Limitations and Conclusions

  • The research had a few limitations, including that it did not record complications in the 24 hours after the procedure. Furthermore, the decision to give additional pain relief was dependent on the surgeon’s assessment, not a standardised plan based on pain scores.
  • In conclusion, administering local mepivacaine before castration helped improve anaesthesia quality, post-operative cytokines levels, and reduced pain even after providing balanced anaesthesia with multimodal analgesia in control horses.

Cite This Article

APA
Abass M, Picek S, Garzón JFG, Kühnle C, Zaghlou A, Bettschart-Wolfensberger R. (2018). Local mepivacaine before castration of horses under medetomidine isoflurane balanced anaesthesia is effective to reduce perioperative nociception and cytokine release. Equine Vet J, 50(6), 733-738. https://doi.org/10.1111/evj.12947

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 50
Issue: 6
Pages: 733-738

Researcher Affiliations

Abass, M
  • Equine Department, Division of Anaesthesiology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
  • Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt.
Picek, S
  • Equine Department, Division of Anaesthesiology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
Garzón, J F G
  • Institute of Physiology, University of Zurich, Zurich, Switzerland.
Kühnle, C
  • Equine Department, Division of Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
Zaghlou, A
  • Department of Surgery, Anaesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt.
Bettschart-Wolfensberger, R
  • Equine Department, Division of Anaesthesiology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

MeSH Terms

  • Analgesics / administration & dosage
  • Anesthesia / methods
  • Anesthesia / veterinary
  • Anesthetics, Local / administration & dosage
  • Animals
  • Arterial Pressure / drug effects
  • Cardiotonic Agents / administration & dosage
  • Clonixin / administration & dosage
  • Clonixin / analogs & derivatives
  • Cytokines / blood
  • Cytokines / metabolism
  • Diazepam / administration & dosage
  • Dobutamine / administration & dosage
  • Double-Blind Method
  • Horses / physiology
  • Horses / surgery
  • Hypnotics and Sedatives / administration & dosage
  • Isoflurane / administration & dosage
  • Ketamine / administration & dosage
  • Male
  • Medetomidine / administration & dosage
  • Mepivacaine / administration & dosage
  • Nociceptive Pain / prevention & control
  • Orchiectomy / veterinary
  • Pain, Postoperative / prevention & control
  • Pain, Postoperative / veterinary
  • Prospective Studies
  • Random Allocation

Grant Funding

  • Egyptian Ministry of Higher Education and Scientific Research (MHESR)

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Citations

This article has been cited 7 times.
  1. Vullo C, Crupi R, Di Paola R, Cuzzocrea S, Gugliandolo E, Biondi V, Catone G. Intratesticular Versus Intrafunicular Lidocaine to Reduce Perioperative Nociception and Immunological Response in Ponies Undergoing Field Castration. Vet Sci 2022 Nov 28;9(12).
    doi: 10.3390/vetsci9120664pubmed: 36548825google scholar: lookup
  2. Lemonnier LC, Thorin C, Meurice A, Dubus A, Touzot-Jourde G, Couroucé A, Leroux AA. Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses. Animals (Basel) 2022 Feb 21;12(4).
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