Comparison of 2% lidocaine and hyperbaric 5% lidocaine for caudal epidural analgesia in horses

DeRossi, Rafael; Frazílio, Fabrício Oliveira; Miguel, Gabriel Lima e Silva; Kassab, Tamer Ali

doi:10.1016/j.jevs.2005.04.003

Cited by 6 publications

(14 citation statements)

References 22 publications

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“…According to literature, the loss of motor function is reported to happen immediately or in the first 15 min following injection 15 16. The spread of the solution through the epidural canal is influenced by volume, concentration, solubility of the drug used and velocity of the injection 17 18.…”

Section: Discussionmentioning

confidence: 99%

Collapse in a mare during standing sedation with a fatal outcome

Carrozzo¹,

Ambros²

2020

Vet Record Case Reports

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A 6-year-old 559-kg Canadian Warmblood mare with lacerations over the neck and all four limbs was presented to the Western College Veterinary Medicine. Medical treatment and wound lavage was carried out for 5 days with no clinical improvement. Ultrasonography of the gluteal region showed disruption of normal muscle architecture, predominantly on the right side. A diagnosis of compartmental syndrome was confirmed with intracompartment pressure measurements. Fasciotomy of the semimembranosus and tendinosus muscles was elected. Standing sedation was achieved with intermittent boluses of butorphanol and detomidine, and caudal epidural analgesia was performed with 13 mL of lidocaine 2 per cent. Forty minutes after the epidural injection, the mare became ataxic and fell. The horse was anaesthetised with ketamine and diazepam followed by total intravenous anaesthesia until the effects of the epidural lidocaine were presumed to have resolved. In recovery, the mare was unable to stand. The owner elected humane euthanasia.

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Section: Discussionmentioning

confidence: 99%

Collapse in a mare during standing sedation with a fatal outcome

Carrozzo¹,

Ambros²

2020

Vet Record Case Reports

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“…Thus, it is more probable that the analgesic effect at the hindlimb region was simply just undetectable by the mechanical stimulation modalities. In this study, nociceptive threshold testing was performed using mechanical nociceptive stimulation of the skin by needle pricks and haemostat pinching, which are the most commonly described nociceptive threshold‐testing modalities for assessment of epidural analgesia in horses (Gómez de Segura et al 1998; Kariman et al 2000; Skarda and Muir 2001a,b; Ganidagli et al 2004; Natalini et al 2004; DeRossi et al 2004; 2005a,b; 2012a,b; 2013). These test modalities have the advantage of being simple to perform with no special equipment required; however, they also have a number of scientific limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Analgesia was assessed by mechanical nociceptive threshold testing consisting of skin needle prick (using a 23 gauge 2.5 cm long needle) and a pinch with a haemostat (closed to the first ratchet) (Gómez de Segura et al 1998; Kariman et al 2000; Skarda and Muir 2001a,b; Ganidagli et al 2004; Natalini et al 2004; DeRossi et al 2004; 2005a,b; 2012a,b; 2013). Both tests of analgesia were performed bilaterally at well‐defined dermatomal stimulation points located within different dermatomes ( Fig ).…”

Section: Methodsmentioning

confidence: 99%

Caudal epidural co‐administration of methadone and morphine in horses: An evaluation of analgesic properties and effects on locomotor function, mentation and physical examination parameters

Kjærulff¹,

Lauritsen²,

Ekstrøm

et al. 2020

Equine Veterinary Education

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Summary Caudal epidural analgesia is a well‐established therapeutic modality for pain alleviation in horses. Additionally, epidural analgesia could potentially be a complementary diagnostic tool for confirmation of pain‐related conditions in horses presenting with nonspecific signs of poor performance or rideability issues. To use the epidural as a diagnostic tool, the administered medications should provide efficient analgesia without accompanying adverse effects. Therefore, the objectives of the current study were to evaluate the analgesic properties and effects on locomotor function, mentation and physical examination parameters of caudal epidural co‐administration of methadone and morphine in horses. Five mares received a caudal epidural injection of 0.1 mg/kg bwt methadone and 0.1 mg/kg bwt morphine diluted to a total volume of 4.4 mL/100 kg. Before and several times thereafter, horses were subjected to mechanical nociceptive threshold evaluation, physical examination, assessment of mentation and locomotor function examination. Horses were assigned ataxia scores (0–4) by a group of inexperienced raters (three senior‐year veterinary students) and a group of experienced raters (two board‐certified internal medicine specialists) that assessed the locomotor examinations either live or video‐based. The epidural co‐administration of methadone and morphine resulted in clinically relevant and statistically significant increases of horses’ tolerance to mechanical noxious stimuli at the coccygeal, perineal, sacral, lumbar and thoracic regions. Analgesia was evident after 4.4 h and lasted at least 5 h. Regional differences in the onset of analgesia reflected a cranial spread of the analgesic solution. No horses showed signs of gait disturbances; the overall median ataxia score was 0 at all times; and the average difference in scores between two randomly selected raters for a random horse at a random time point was 0.377 indicating high inter‐rater agreement. There were no adverse changes of mentation and physical examination parameters. Observed side effects included signs of decreased frequency of defaecation, generalised sweating, and pruritus.

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“…Compared to plain solutions, hyperbaric solutions might provide a more predictable block with fewer side effects, such as high block, hypotension, nausea, vomiting, and pruritus 8 . As hyperbaric solutions have higher density when compared with a reference standard, they develop enough interstitial pressure to cause diffusion of injected material in the dependent regions 9 . The blocked regions were innervated by the radial, median, ulnar, musculo-cutaneous and axillary nerves, and in every region of the limb the BPB blocked more effectively.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of two regional anesthetic methods on the front limb of dogs using hyperbaric bupivacaine

2010

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PURPOSE: To evaluate the effects of bupivacaine 0.5 and 0.25% in intravenous regional anesthesia (IVRA) and brachial plexus block (BPB), respectively, on anesthesia, motor block and cardiovascular parameters in dogs. METHODS: Fourteen healthy adult dogs averaging 10 kilograms (kg) of body weight. Animals were randomly assigned to receive one of the two treatments IVRA (n=7) or BPB (n=7). All the animals were sedated with acepromazine (0.1 mg/kg intramuscular). To execute the BPB was used an electrical nerve stimulation. Anesthesia, motor block, sedation, cardiovascular and respiratory effects were measured as effect of the treatment. RESULTS: BPA showed superior efficiency and duration of anesthesia (BPB - 456 ± 94 minutes vs IVRA - 138 ± 44) as well as motor block. There only physiologic parameter which change were the systolic pressure in BPB and respiratory rate for both treatments. CONCLUSION: In dogs the 0.25 % hyperbaric bupivacaine in BPB produces a front limb anesthesia about three times more than the 0.5 % in IVRA, with ptosis of the limb blocked and little interference in the cardiovascular system but with decrease in respiratory rate.

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Comparison of 2% lidocaine and hyperbaric 5% lidocaine for caudal epidural analgesia in horses

Cited by 6 publications

References 22 publications

Collapse in a mare during standing sedation with a fatal outcome

Collapse in a mare during standing sedation with a fatal outcome

Caudal epidural co‐administration of methadone and morphine in horses: An evaluation of analgesic properties and effects on locomotor function, mentation and physical examination parameters

Evaluation of two regional anesthetic methods on the front limb of dogs using hyperbaric bupivacaine

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