Complications of Loco‐Regional Anesthesia

García, Eva Rioja

doi:10.1002/9781119190332.ch14

Cited by 4 publications

(9 citation statements)

References 96 publications

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“…Neurologic sequelae of epidural analgesia were observed with dose administration, and ataxia and recumbency have been reported in prior studies (3,17,18,28). Morphine administered epidurally alone does not cause motor impairment (3, 7).…”

Section: Discussionmentioning

confidence: 69%

“…Technical complications related to problems with the epidural catheter system have previously been reported for people and veterinary species (18,28,40,41). In the retrospective study by Martin et al, technical complications were observed for 22 of 50 catheters and included catheter dislodgement, dislodgement of the catheter adapter or filter, obstruction of the catheter, and leaks from any part of the catheter system (18).…”

Section: Discussionmentioning

confidence: 94%

“…The descriptions included verbiage describing a range in severity from mild to severe and continuous. Severe pruritus can lead to damage to the catheter system, skin irritation and cutaneous breakdown with potential subsequent infection, increased discomfort, and patient distress leading to premature cessation of the analgesic strategy (28,46,49). Neither histamine release nor the composition of the morphine solution is believed to cause the pruritus, and the exact mechanism is not well-understood (47,49).…”

Section: Discussionmentioning

confidence: 99%

“…While we routinely integrate epidural catheterization and epidural analgesia administration into our clinical practice, it has been our clinical impression that the frequency and description of complications has been under-reported (3,17,18,24,28). Thus, the purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

et al. 2022

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The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent placement of a caudal epidural catheter for analgesic management between 2017 and 2021 were analyzed retrospectively. For the 62 catheters placed in the 48 cases, the most frequent diagnosis category prompting epidural analgesia was orthopedic (43/48, 89.6%). Synovial sepsis was the most frequent specific diagnosis prompting epidural catheter placement (11/48, 22.9%). The initial response to epidural therapy was characterized as positive for 37/62 (59.7%) catheters. Complications were documented for 46/62 (74.2%) catheters. However, most of these complications were classified as mild (51.6%) or moderate (14.5%), and exaggerated physiologic responses were observed most frequently. Of the horses studied, 52.1% survived to be discharged from the hospital. With awareness of potential complications and vigilant monitoring, caudal epidural catheters should be considered for equine patients as an analgesic strategy.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

et al. 2022

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“…The obtained information in this study will allow a better understanding of the true anatomical position of this nervous segment and its variations in live horses, generating more accurate information regarding the best location to perform the perineural injection, the choice of the appropriate needle size and possible inadvertent infiltrations that may reduce the efficiency of the anaesthetic block and obscure the interpretation of the response after the injection is performed (Garcia, 2021).…”

Section: Introductionmentioning

confidence: 99%

Anatomical position of the palmar/plantar nerves at the metacarpal/metatarsal distal level in horses: An in vivo study by means of ultrasonography

Maia

Vendrusculo

Souza

et al. 2022

Anat Histol Embryol

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The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4‐ or 6‐point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Images were obtained for measurements of the cross‐sectional area of the nerve, distances between the nerve and the skin surface, branch of the suspensory ligament (SL), deep digital flexor tendon (DDFT) and superficial digital flexor tendon (SDFT) with limbs supported and elevated. The distance to the skin for forelimbs was higher on the lateral side when the limb was elevated (p < 0.001). The comparisons between supported and elevated limbs on the same side showed longer distances to the skin with the limb supported on the medial side (p < 0.001). Hindlimbs showed longer distances to the skin with the limb supported on the medial face (p = 0.027). The anatomical position of palmar/plantar nerves was similar between the lateral and medial sides of the limb, generally being in contact with the dorsal edge of DDFT. The strategy of elevating the limb during the injection of the low 4‐ or 6‐point block can lead to a higher risk of puncture of the digital sheath.

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Program and Abstracts

2023

Tissue Engineering Part A

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Complications of Loco‐Regional Anesthesia

Cited by 4 publications

References 96 publications

Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

Anatomical position of the palmar/plantar nerves at the metacarpal/metatarsal distal level in horses: An in vivo study by means of ultrasonography

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