Efficacy of concurrent epidural administration of neostigmine and lidocaine for perineal analgesia in geldings

DeRossi, Rafael; Maciel, Felipe B.; Módolo, Tiago José Caparica; Pagliosa, Ronaldo C.

doi:10.2460/ajvr.73.9.1356

Cited by 14 publications

(8 citation statements)

References 28 publications

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“…More importantly, magnesium sulphate is a noncompetitive NMDA receptor antagonist with analgesic properties, and it is therefore an effective adjuvant to Caudal epidural anaesthesia and analgesia in horses lidocaine, resulting in significantly prolonged duration of epidural anaesthesia (Sadegh and Shafiei 2008). Similar findings of prolonged duration of anaesthesia have been reported when epidural lidocaine is combined with neostigmine (an acetylcholinesterase inhibitor) (Derossi et al 2012a(Derossi et al , 2013, although the beneficial effect of this combination has not been consistently shown (Valadares et al 2017).…”

Section: Epidural Drug Combinationsmentioning

confidence: 78%

“…Local anaesthetics produce nonselective sympathetic, sensory and motor nerve blockade by preventing depolarisation of the nerve membrane and conduction of nerve impulses (Robinson and Natalini 2002;Carpenter and Byron 2015). The most commonly used local anaesthetic for epidural application in horses is lidocaine 2%, which has a rapid onset (2-15 min) and produces between 1 and 3 h of sensory and motor blockade involving the coccygeal, perineal, sacral and lower lumbar regions as well as the upper region of the pelvic limbs (Olbrich and Mosing 2003;Derossi et al 2005aDerossi et al , 20082012a;2013;Sadegh and Shafiei 2008;Duarte et al 2017;Valadares et al 2017;Ghazaleh et al 2018). Mepivacaine has been reported to have a similar onset (5-30 min) and duration of action (1-3 h) to lidocaine (Skarda and Muir 1983;Skarda et al 1984;Robinson and Natalini 2002;Skarda et al 2005;Michou and Leece 2012;Carpenter and Byron 2015;Bird et al 2019).…”

Section: Local Anaestheticsmentioning

confidence: 99%

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A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 1: Safety and efficacy of epidural drugs

Kjærulff

Lindegaard

2021

Equine Veterinary Education

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The importance of adequate pain management in horses has gained increased clinical attention over the last decade or so, and many drugs and administration techniques have been investigated for the purpose of improving equine pain management. Caudal epidural anaesthesia and analgesia (CEAA) has the potential to be one of the most efficient techniques for management of moderate to severe pain of the pelvic limbs, the caudal part of the body and even the thoracic limbs. The epidural administration of many different drugs has been studied and clinically applied, most of them with good efficacy and minimal side-effects. In order to guide the clinician on when and how to perform CEAA in horses, this 2-part review provides a detailed review of the efficacy, safety, indications and techniques. Part 1 focuses on the efficacy and safety of epidurally administered drugs and Part 2 considers indications and contraindications, and provides a practical description on how to perform the epidural procedure. Epidural drugsThe goal when selecting drugs for epidural injections is to achieve efficient regional anaesthesia or analgesia with appropriate onset, duration and anatomical spread, and

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Section: Epidural Drug Combinationsmentioning

confidence: 78%

Section: Local Anaestheticsmentioning

confidence: 99%

A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 1: Safety and efficacy of epidural drugs

Kjærulff

Lindegaard

2021

Equine Veterinary Education

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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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“… 14 Moreover, by preventing the migration and activation of lymphocytes, lidocaine can mitigate local inflammatory response-induced central hyperalgesia and postoperative pain. 15 …”

Section: Dicussionmentioning

confidence: 99%

Effects of intravenously infused lidocaine on analgesia and gastrointestinal function of patients receiving laparoscopic common bile duct exploration

Yang¹,

Hu²

2015

Pak J Med Sci

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Objective:To evaluate the effects of intravenously infused lidocaine on analgesia and gastrointestinal function of patients receiving laparoscopic common bile duct exploration.Methods:Seventy-eight patients with cholelithiasis were randomly divided into a treatment group and a control group (n=39) that all had laparoscopic common bile duct exploration. The treatment group was intravenously infused with 1.5 mg/kg lidocaine by using a venous pump under anesthesia induction at the speed of 2 mg·kg-1 ·h-1 until the end of surgery, while the control group was given normal saline with the same volume.Results:All patients successfully completed the surgery, with similar surgical time, incision length and intraoperative blood loss. The required lidocaine concentrations of the treatment group were 2.64±1.23 μg/ml, 1.14±0.4 μg/ml and 0.93±0.32 μg/ml respectively 2 hour, 12 hour and 48 hour after surgery. Pain score of the treatment group, which was significantly lower than that of the control group at the postoperative 2 hour (P<0.05), was similar to those of the control group at the postoperative 12 hour and 48 hour. With extended time, the pain score significantly decreased (P<0.05). The treatment group had significantly shorter first anal exhaust time and first defecation time than those of the control group (P<0.05). Adverse reactions, such as nausea and vomiting, dizziness, headache, subcutaneous emphysema and fat liquefaction of incision, occurred similarly in the two groups, which were alleviated by symptomatic treatment.Conclusion:Laparoscopic common bile duct exploration is a promising minimally invasive surgery for patients with cholelithiasis, during which intravenously infused lidocaine can rapidly recover the gastrointestinal function and exert short-term analgesic effects, with mild adverse reactions also.

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Efficacy of concurrent epidural administration of neostigmine and lidocaine for perineal analgesia in geldings

Cited by 14 publications

References 28 publications

A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 1: Safety and efficacy of epidural drugs

A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 1: Safety and efficacy of epidural drugs

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

Effects of intravenously infused lidocaine on analgesia and gastrointestinal function of patients receiving laparoscopic common bile duct exploration

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