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Equine veterinary journal2026; doi: 10.1002/evj.70327

Use of a caudal intercostal block in horses undergoing surgery for colic.

Abstract: In humans and companion animals, regional anaesthesia is used in multimodal analgesic protocols for abdominal wall surgery. Benefits include earlier patient mobilisation and improved pain scores. Regional anaesthetic techniques for horses undergoing abdominal surgery could provide similar benefits and warrant investigation. Objective: To evaluate the safety and efficacy of a caudal intercostal block for abdominal surgery (CIBAS) in horses undergoing surgery for colic. Methods: Blinded, randomised clinical trial. Methods: Horses (n = 22) undergoing exploratory celiotomy for colic were randomly assigned to receive CIBAS (1 mg/kg bupivacaine, 1 μg/kg epinephrine and 1 μg/kg dexmedetomidine), or an equivalent volume of saline (control). Recovery quality was assessed by blinded personnel using a semi-quantitative rubric. Pain scores for the first 24-h postoperatively were assigned by blinded observers trained to use validated composite visceral and facial pain scales. A Chi-square test for trend was used to compare recovery scores between groups, and an unpaired t-test was used to compare the area under the curve (AUC) for composite pain scores between groups. Results: Horses receiving CIBAS had significantly better recovery scores than those in the saline group (median 3, IQR [3, 4] p = 0.05). CIBAS horses also had significantly lower AUC pain scores (243.9; 95% CI [172.1, 315.8]) than horses receiving saline (331.1; 95% CI [233.9, 428.4] p = 0.0002). Conclusions: Unstandardised anaesthetic protocols, use of a semiquantitative recovery score, CIBAS not tested for efficacy, and small sample size. Conclusions: CIBAS is safe to perform. Horses that received CIBAS had significantly better recovery scores and significantly lower pain scores over the first 24-h postoperatively, compared to horses that received saline. Supplies to perform the block are inexpensive and accessible to most clinicians. CIBAS can be considered a safe option in horses undergoing exploratory celiotomy.
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Publication Date: 2026-09-15 PubMed ID: 42740672DOI: 10.1002/evj.70327Google Scholar: Lookup
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  • 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.

Overview

  • This study evaluated the safety and effectiveness of a specific regional anaesthetic technique, the caudal intercostal block (CIBAS), in horses undergoing surgery for colic.
  • The research found that horses receiving CIBAS experienced better recovery quality and lower postoperative pain compared to controls given saline.

Background and Rationale

  • In human and companion animal medicine, regional anaesthesia is commonly used as part of multimodal pain management strategies during abdominal surgeries.
  • Benefits observed include reduced pain intensity and earlier mobilisation post-surgery.
  • Horses undergoing abdominal surgery, such as exploratory celiotomy for colic, might benefit from similar regional anaesthetic techniques, but this had not been extensively studied.

Objective

  • To determine the safety and effectiveness of the caudal intercostal block for abdominal surgery (CIBAS) in horses undergoing colic surgery.

Methods

  • Study Design:

    • Blinded, randomized clinical trial.
  • Subjects:

    • 22 horses undergoing exploratory celiotomy for colic.
  • Intervention:

    • Horses randomly assigned to receive either the CIBAS block—comprising 1 mg/kg bupivacaine, 1 μg/kg epinephrine, and 1 μg/kg dexmedetomidine—or an equivalent volume of saline as a control.
  • Outcomes measured:

    • Recovery quality, assessed by blinded personnel using a semi-quantitative rubric.
    • Postoperative pain scores during the first 24 hours, assessed by trained, blinded observers using validated composite visceral and facial pain scales.
  • Statistical Analysis:

    • Recovery scores compared using chi-square test for trend.
    • Postoperative pain scores analyzed by calculating area under the curve (AUC), compared by unpaired t-test.

Results

  • Horses receiving CIBAS had significantly improved recovery quality (median score 3, interquartile range [3, 4]) compared to saline controls (p = 0.05).
  • Postoperative pain scores as measured by AUC were significantly lower in the CIBAS group (243.9; 95% CI [172.1, 315.8]) compared to saline group (331.1; 95% CI [233.9, 428.4]; p = 0.0002).

Conclusions and Implications

  • CIBAS is safe to perform in horses undergoing colic surgery.
  • It significantly reduces postoperative pain and improves recovery quality in the first 24 hours post-surgery.
  • The materials needed to perform the block are inexpensive and generally accessible to clinicians.
  • CIBAS can be considered a viable and safe option to include in analgesic protocols for horses undergoing exploratory celiotomy.

Limitations

  • Use of unstandardised anaesthetic protocols which could introduce variability.
  • Recovery scoring was semi-quantitative, which might be subjective.
  • The block’s efficacy was not tested before clinical use in this study.
  • Small sample size limits generalisability and statistical power.

Summary

  • This study supports the potential benefits of using a regional anaesthetic technique like CIBAS in horses to reduce post-surgical pain and improve recovery.
  • It paves the way for further exploration with larger sample sizes and more standardised protocols.

Cite This Article

APA
Burke MJ, Sheahan BJ, Young KA, Briley JD, Fogle C. (2026). Use of a caudal intercostal block in horses undergoing surgery for colic. Equine Vet J. https://doi.org/10.1002/evj.70327

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Burke, Megan J
  • Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA.
Sheahan, Breanna J
  • Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA.
Young, Kim A
  • Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA.
Briley, Jessica D
  • Department of Molecular and Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA.
Fogle, Callie
  • Department of Clinical Sciences, Clemson University College of Veterinary Medicine, Clemson, South Carolina, USA.

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