FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Systemic and local effects of lidocaine or mepivacaine when ...
Equine veterinary journal2020; 52(5); 743-751; doi: 10.1111/evj.13236

Systemic and local effects of lidocaine or mepivacaine when used for intravenous regional anaesthesia of the distal limb in standing sedated horses.

Abstract: Local anaesthetics are being combined clinically with amikacin in intravenous regional limb perfusion (IVRLP), with limited knowledge on the analgesia provided and its onset and duration of action after tourniquet application and release. Objective: To evaluate the systemic clinical effect, limb withdrawal to nociceptive stimulation, and plasma and synovial fluid concentrations after IVRLP with lidocaine or mepivacaine in standing sedated horses. Methods: Prospective, controlled, randomised, cross-over study. Methods: Six healthy adult horses were sedated and received IVRLP with lidocaine, mepivacaine or saline (negative control), or perineural anaesthesia of the medial and lateral palmar and palmar metacarpal nerves (positive control) in one forelimb with a 3-week washout period between trials. Electrical and mechanical stimuli were used to test nociceptive threshold of the limb before and after IVRLP/perineural anaesthesia. For lidocaine and mepivacaine trials, blood was collected from the jugular vein and synovial fluid from the radiocarpal joint before, during and out to 24 hours after IVRLP. Drug concentrations were measured using high-performance liquid chromatography. Results: Nociceptive thresholds for lidocaine, mepivacaine and perineural anaesthesia trials were significantly increased compared with saline and baseline values at 10, 20 and 30 minutes, with no differences between anaesthetic trials. During this time, horses had lower heart rates than IVRLP with saline. After tourniquet release at 30 minutes, nociceptive thresholds for lidocaine and mepivacaine trials gradually returned to baselines, whereas perineural anaesthesia trial remained unchanged out to an hour. Plasma lidocaine and mepivacaine concentrations were ≤50 ng/mL while the tourniquet was in place, significantly increasing 10 minutes after tourniquet release. Maximal lidocaine and mepivacaine concentrations in synovial fluid were reached 25 minutes after IVRLP injection. Conclusions: Amikacin was not included in the perfusate. Conclusions: Similar to perineural anaesthesia, IVRLP with lidocaine or mepivacaine provides anti-nociception to the distal limb in standing sedated horses while a tourniquet is applied with concentrations remaining below toxic levels in plasma and synovial fluid.
© 2020 EVJ Ltd.
Get Full Text
Publication Date: 2020-02-21 PubMed ID: 31972065DOI: 10.1111/evj.13236Google 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.

The study investigates the systemic and local effects of using lidocaine or mepivacaine for intravenous regional anaesthesia in horses. It finds that both drugs provide similar levels of anti-nociception to the distal limb in horses, similar to perineural anaesthesia, while maintaining safe levels of concentration in plasma and synovial fluid.

Research Context

  • The focus of the research is to explore the implications of using lidocaine or mepivacaine in intravenous regional limb perfusion (IVRLP) in horses, with a special emphasis on understanding the measure of analgesia provided.
  • There’s limited knowledge on how these anaesthetics work in terms of onset and duration of action particularly after the application and release of a tourniquet during the process.

Research Methodology

  • The methodology involved a prospective, controlled, randomized, cross-over study which involved six healthy adult horses.
  • Each horse was sedated and received IVRLP with either lidocaine, mepivacaine or saline (as a negative control), or were given perineural anaesthesia.
  • A 3-week washout period was observed between trials to avoid any interference or overlaps in results.
  • Electrical and mechanical stimuli were used to measure the nociceptive threshold of the limb before and after IVRLP or perineural anaesthesia.
  • Blood and synovial fluid samples were collected at different stages for drug concentration analysis done through high-performance liquid chromatography.

Research Findings

  • The nociceptive thresholds for both lidocaine and mepivacaine were significantly increased compared with saline and initial values at 10, 20, and 30 minutes.
  • There were no significant differences between the various anaesthetic trials themself.
  • Lower heart rates were observed in horses during IVRLP with these anaesthetics compared with saline.
  • After tourniquet release at 30 minutes, nociceptive thresholds gradually returned to baseline levels for lidocaine and mepivacaine trials, while the perineural anaesthesia trial showed unaltered effects up to an hour.
  • Both lidocaine and mepivacaine showed a significant increase in plasma concentrations 10 minutes post-tourniquet release, but remained at safe levels.
  • Maximal lidocaine and mepivacaine concentrations in synovial fluid were observed at around 25 minutes post-IVRLP injection.

Conclusion

  • The study concludes that both lidocaine and mepivacaine exert similar anaesthetic effects to perineural anaesthesia when used in IVRLP.
  • Both anaesthetics provide sufficient anti-nociception to the distal limb in sedated horses while the tourniquet is applied.
  • These effects and the drug concentrations remain safely below toxic levels in plasma and synovial fluid.

Cite This Article

APA
Mendez-Angulo JL, Granados MM, Modesto R, Serrano-Rodriguez JM, Funes FJ, Quiros S, Gomez-Villamandos RJ, Zaldívar S, Trumble TN. (2020). Systemic and local effects of lidocaine or mepivacaine when used for intravenous regional anaesthesia of the distal limb in standing sedated horses. Equine Vet J, 52(5), 743-751. https://doi.org/10.1111/evj.13236

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 5
Pages: 743-751

Researcher Affiliations

Mendez-Angulo, Jose L
  • Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain.
Granados, Maria M
  • Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain.
Modesto, Rolf
  • Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA.
Serrano-Rodriguez, Juan M
  • Department of Pharmacology, Toxicology and Legal and Forensic Medicine, University of Córdoba, Córdoba, Spain.
Funes, Francisco J
  • Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain.
Quiros, Setefilla
  • Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain.
Gomez-Villamandos, Rafael J
  • Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain.
Zaldívar, Sara
  • Department of Genetics, University of Córdoba, Córdoba, Spain.
Trumble, Troy N
  • Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA.

MeSH Terms

  • Anesthesia, Conduction / veterinary
  • Anesthetics, Local
  • Animals
  • Anti-Bacterial Agents
  • Cross-Over Studies
  • Forelimb
  • Horses
  • Lidocaine
  • Mepivacaine
  • Prospective Studies
  • Synovial Fluid

Grant Funding

  • University of Cu00f3rdoba

References

This article includes 27 references
  1. Senior JM. Morbidity, mortality, and risk of general anaesthesia in horses.. Vet Clin North Am Equine Pract 2013;29:1-18.
  2. O'Brien T, Hunt RJ. Recent advances in standing equine orthopedic surgery.. Vet Clin North Am Equine Pract 2014;30:221-37.
  3. Payne RJ, Compston PC. Short- and long-term results following standing fracture repair in 34 horses.. Equine Vet J 2012;44:721-5.
  4. Hoerdemann M, Smith RL, Hosgood G. Duration of action of mepivacaine and lidocaine in equine palmar digital perineural blocks in an experimental lameness model.. Vet Surg 2017;46:986-93.
  5. van Zundert A, Helmstadter A, Goerig M, Mortier E. Centennial of intravenous regional anesthesia. Bier's Block (1908-2008).. Reg Anesth Pain Med 2008;33:483-9.
  6. Weaver AD. Intravenous local anesthesia of the lower limb in cattle.. J Am Vet Med Assoc 1972;160:55-7.
  7. Prentice DE, Wyn-Jones GW, Jones RS, Jagger DW. Intravenous regional anaesthesia of the bovine foot.. Vet Rec 1974;94:293-5.
  8. Babalola GO, Oke BO. Intravenous regional analgesia for surgery of the limbs in goats.. Vet Q 1983;5:186-9.
  9. Modesto RB, Tatarniuk DM, Mendez-Angulo JL, Almeida DC, Trumble TN. The clinical use of intravenous regional limb perfusion with lidocaine to perform minor surgical procedures in the equine distal limb:short- and long-term effects in 23 horses.. Vet Surg 2014;43:E186-187.
  10. Colbath AC, Wittenburg LA, Gold JR, McIlwraith CW, Moorman VJ. The effects of mepivacaine hydrochloride on antimicrobial activity and mechanical nociceptive threshold during amikacin sulfate regional limb perfusion in the horse.. Vet Surg 2016;45:798-803.
  11. Mahne AT, Rioja E, Marais HJ, Villarino NF, Rubio-Martinez LM. Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses.. Equine Vet J 2014;46:375-9.
  12. Meyer GA, Lin HC, Hanson RR, Hayes TL. Effects of intravenous lidocaine overdose on cardiac electrical activity and blood pressure in the horse.. Equine Vet J 2001;33:434-7.
  13. Ringer SK, Portier KG, Fourel I, Bettschart-Wolfensberger R. Development of a xylazine constant rate infusion with or without butorphanol for standing sedation of horses.. Vet Anaesth Analg 2012;39:1-11.
  14. Baxter GM, Stashak TS. Perineural and intrasynovial anaesthesia.. In: Baxter GM, editor. Adams and Stashak's lameness in horses. 6th ed. Singapore: Blackwell Publishing Ltd, 2011; p. 173-202.
  15. Moens Y, Lanz F, Doherr MG, Schatzmann U. A comparison of the antinociceptive effects of xylazine, detomidine and romifidine on experimental pain in horses.. Vet Anaesth Analg 2003;30:183-90.
  16. Jordana M, Martens A, Duchateau L, Vanderperren K, Saunders J, Oosterlinck M. Distal limb desensitisation following analgesia of the digital flexor tendon sheath in horses using four different techniques.. Equine Vet J 2014;46:488-93.
  17. Driessen B, Scandella M, Zarucco L. Development of a technique for continuous perineural blockade of the palmar nerves in the distal equine thoracic limb.. Vet Anaesth Analg 2008;35:432-48.
  18. Rofael HZ, Abdel-Rahman MS. Development and validation of a high-performance liquid chromatography method for the determination of cocaine, its metabolites and ketamine.. J Appl Toxicol 2002;22:123-8.
  19. Sellers G, Lin HC, Riddell MG, Ravis WR, Duran SH, Givens MD. Pharmacokinetics of lidocaine in serum and milk of mature Holstein cows.. J Vet Pharmacol Ther 2009;32:446-50.
  20. Bogan JA, Weaver AD. Lidocaine concentrations associated with intravenous regional anaesthesia of the distal limb of cattle.. Am J Vet Res 1978;39:1672-3.
  21. Malone E, Ensink J, Turner T, Wilson J, Andrews F, Keegan K. Intravenous continuous infusion of lidocaine for treatment of equine ileus.. Vet Surg 2006;35:60-6.
  22. Prieto-Alvarez P, Calas-Guerra A, Fuentes-Bellido J, Martinez-Verdera E, Benet-Catala A, Lorenzo-Foz JP. Comparison of mepivacaine and lidocaine for intravenous regional anaesthesia: pharmacokinetic study and clinical correlation.. Br J Anaesth 2002;88:516-9.
  23. Henderson CL, Warriner CB, McEwen JA, Merrick PM. A North American survey of intravenous regional anesthesia.. Anesth Analg 1997;85:858-63.
  24. Guay J. Adverse events associated with intravenous regional anesthesia (Bier block): a systematic review of complications.. J Clin Anesth 2009;21:585-94.
  25. Mather LE, Cousins MJ. Local anaesthetics and their current clinical use.. Drugs 1979;18:185-205.
  26. Park J, Sutradhar BC, Hong G, Choi SH, Kim G. Comparison of the cytotoxic effects of bupivacaine, lidocaine, and mepivacaine in equine articular chondrocytes.. Vet Anaesth Analg 2011;38:127-33.
  27. Piat P, Richard H, Beauchamp G, Laverty S. In vivo effects of a single intra-articular injection of 2% lidocaine or 0.5% bupivacaine on articular cartilage of normal horses.. Vet Surg 2012;41:1002-10.

Citations

This article has been cited 1 times.
  1. Loppnow Z, Kersh K, Wang C, Spaethe S, Troy J. Clinical use of antimicrobial regional limb perfusion in adult horses diagnosed with synovial sepsis or penetrating synovial wounds at a single equine referral hospital in the Midwest United States-163 cases (2010-2020). Front Vet Sci 2025;12:1504486.
    doi: 10.3389/fvets.2025.1504486pubmed: 40206250google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.