Clinical Assessment of an Ipsilateral Cervical Spinal Nerve Block for Prosthetic Laryngoplasty in Anesthetized Horses

Abstract

The nociceptive blockade of locoregional anesthesia prior to surgical stimulation can decrease anesthetic agent requirement and thereby potential dose-dependent side effects. The use of an ipsilateral second and third cervical spinal nerve locoregional anesthetic block for prosthetic laryngoplasty in the anesthetized horses has yet to be described. Anesthetic records of 20 horses receiving locoregional anesthesia prior to laryngoplasty were reviewed and compared to 20 horses of a similar patient cohort not receiving locoregional anesthesia. Non-blocked horses were 11 times more likely to require adjunct anesthetic treatment during surgical stimulation (P = 0.03) and were 7.4 times more likely to receive partial intravenous anesthesia in addition to inhalant anesthesia (P = 0.01). No horse in the blocked group received additional sedation/analgesia compared to the majority of non-blocked horses (75%) based on the anesthetist's perception of anesthetic quality and early recovery movement. No difference in recovery quality was observed between groups (P > 0.99). Cervical spinal nerve locoregional anesthesia appears well-tolerated and useful in reducing cumulative anesthetic agent requirement and may decrease the need for additional sedation/analgesia in horses undergoing anesthetized prosthetic laryngoplasty.

Transient Horner's syndrome in horses following cervical plexus local anesthesia

“…The technique is relatively new, and previously published case series have not reported the development of this syndrome associated with the block. 1,3 All cases resolved spontaneously over a period consistent with the duration of action of mepivacaine. 4 In our experience, the block is an effective method of facilitating standing laryngoplasty, and has been shown by others to reduce substantially the need for administration of adjunctive anesthetic or intravenous anesthesia when laryngoplasty is performed under volatile anesthesia.…”

“…2 As far as the authors are aware, there are only two published case series on horses that have received the cervical plexus block; neither reports any complications related to the injection. 1,3 This paper reports a series of cases with transient signs of Horner's syndrome after unilateral cervical plexus block and standing laryngoplasty.…”

Recovery of horses from general anaesthesia: A systematic review (2000–2020) of the influence of anaesthetic protocol on recovery quality

“…Although statistically significant this difference in VAS scores is unlikely to be clinically relevant. Other authors failed to identify a benefit in terms of QR when peripheral nerve blocks were performed prior to recovery 26,125 . Similarly, a group of researchers found no difference in QR in horses receiving either an intra‐articular injection of mepivacaine or saline performed before carpal arthroscopy 126 Although, in three of these studies, 125,126,128 the sample size was small which may hinder the ability to detect a difference between groups.…”

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

“…(1) The effect of epidural xylazine on halothane minimum alveolar concentration in ponies [272] (2) Epidural morphine and detomidine decreases postoperative hindlimb lameness in horses after bilateral stifle arthroscopy [273] (3) Castration of horses under total intravenous anaesthesia: Analgesic effects of lidocaine [274] (4) Local mepivacaine before castration of horses under medetomidine isoflurane balanced anaesthesia is effective to reduce perioperative nociception and cytokine release [275] (5) Intratesticular mepivacaine versus lidocaine in anaesthetised horses undergoing Henderson castration [276] (6) The effect of intra-articular mepivacaine administration prior to carpal arthroscopy on anesthesia management and recovery characteristics in horses [277] 2 / 3 (7) Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis [278] (8) Clinical assessment of an ipsilateral cervical spinal nerve block for prosthetic laryngoplasty in anesthetized horses [279] 4 (9) The outcome of epidural anaesthesia in horses with perineal and tail melanomas: Complications associated with ataxia and the risks of rope recovery [280] 5 / Total loco-regional publications = 9…”

“…Nine publications focused on different loco-regional techniques [272][273][274][275][276][277][278][279][280]. In the last few years, a renaissance of loco-regional techniques on standing horses has occurred with the advent of ultrasound guided technology [469,470].…”