Routes and doses of lignocaine hydrochloride for analgesia of the velvet antler of stags

Pressure Algometry Validation and Determination of Efficacy of Articaine Hydrochloride Ring Block in Antler Removal in Red Deer (Cervus elaphus)

Simple Summary

Red deer (Cervus elaphus) are farmed in New Zealand for the production of velvet antler. Velvet is harvested as living antler tissue, and currently lignocaine is the only licensed local anaesthetic approved for deer antler removal in New Zealand. The use of lignocaine is not without consequences, including drug residues in harvested velvet antler tissue and its short acting analgesic effect. This study was designed to determine the effect of local anaesthetic, articaine hydrochloride as an alternative treatment and to establish the baseline measurements of mechanical nociceptive threshold in 40 male yearling red deer. Ten of the forty enrolled deer were selected for the articaine efficacy study. The mechanical nociceptive thresholds were measured using a handheld algometer applied at 4 points; the cranial, medial, caudal and lateral aspects of the base of each antler. The force applied, which resulted in a movement by the animal, was recorded in newtons (N). This study showed that nociceptive threshold response in deer could be reliably measured, and articaine proved to be a promising alternative for velveting the deer antlers.

Abstract

New Zealand deer farming centres on the production of meat and velvet antler. Velvet antler removal is a painful procedure and currently, New Zealand Animal Welfare regulations dictate surgical removal of velvet antlers under lignocaine anaesthesia. To improve our knowledge on the efficacy and duration of other local anaesthetics to mitigate pain after antler removal, it is important to accurately assess and quantify pain arising from antler removal. Therefore, the current study was designed to validate mechanical nociceptive threshold (MNT) testing using a Wagner hand-held algometer, and to apply this methodology to assess the efficacy and duration of action of articaine for antler removal in deer. Baseline force (N) required to elicit the nociceptive response was recorded in 40 yearling male red deer on three alternate days. Ten of the 40 animals were selected for antler removal after administration of 4% articaine hydrochloride as a ring block. The duration of analgesic efficacy of articaine was assessed by algometry across 5 time points. There was a significant difference in MNTs among the three days (day 3 versus day 1 (p < 0.0001), day 2 versus day 1 (p < 0.0001), and day 1 versus day 2 (p < 0.01)). Positive correlations were observed between weight, antler length and thresholds. The MNT values remained above 20N for 6 h after removal of velvet antlers under the articaine ring block. This study provides valuable information about the use of MNT in red deer. These findings lay a foundation for future studies in the topics of peri-operative and postoperative pain management in deer antler removal, and a possible alternative use for articaine.

Chemical analgesia for velvet antler removal in deer

There is a legal requirement to provide analgesia for velvet antler removal in New Zealand. Currently, this is achieved using local anaesthetic blockade, with or without systemically administered sedative/analgesic agents, or by compression in 1-year-old stags. Lignocaine hydrochloride 2% is most commonly used and is most effective when administered as a high-dose ring block. Combinations of various amino-amide local anaesthetic agents can achieve rapid onset and prolonged duration of analgesia, though concerns about drug residues and carcinogenic potential of a lignocaine metabolite have led to consideration of the amino-ester family of local anaesthetics as alternatives. Systemically administered analgesics, including opioids, alpha-2-adrenergic agents and ketamine provide dose-dependent sedation and analgesia. However, none are sufficient, alone or in combination, to produce surgical analgesia at currently recommended dose rates and when reversal agents are given, analgesic effects are usually reversed as well as sedation. Thus, local anaesthetic blockade is still indicated, though the potential for drug or drug-metabolite residues in velvet antler remains a concern. The need for and effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for post-operative analgesia requires investigation. Amitriptyline, locally administered opioid agonists, tramadol and other systemically administered agents may warrant future investigation for surgical and post-operative analgesia for velvet antler removal.

Welfare of farmed deer in New Zealand. 2. Velvet antler removal

This paper reviews published data on welfare aspects of stag restraint and velvet antler removal, and prevention of antler growth. Several studies of physical restraint and handling demonstrate behavioural and physiological changes both during and after velvet antler removal. Interpretations vary as to whether the act of velvet antler removal imposes a welfare cost additional to that of handling and restraint alone. Chemical restraint presents immediate and delayed welfare risks to the animal. Surgical removal of velvet antler can be achieved without acute pain using a high dose rate of local anaesthetic applied as a ring block, rather than as regional nerve blocks, provided the wait time is adequate. However, there is evidence of less than optimum reproducibility. Lignocaine hydrochloride produces rapid analgesia of short duration, whilst bupivacaine has a delayed onset, but longer duration of analgesia. Mepivacaine has a rapid onset and intermediate duration of analgesia. Mixtures of long and short-acting local anaesthetics provide rapid onset and long duration of analgesia. Present methods for electronic analgesia are aversive and not sufficiently effective. The efficacy and possible aversiveness of compression techniques for inducing analgesia of antlers are currently under evaluation. Post-operative pain and the need for its control have been insufficiently researched. Post-operative sequelae are uncommon, but include clostridial infection. Antler growth in most stags can be prevented by rubber-band application to the growing pedicle, although behavioural changes after ring application suggest this practice may be painful. The procedures used for velvet antler removal, and whether practices are acceptable on the balance of welfare costs and benefits, should be reviewed on an ongoing basis as science, using an increasing range of techniques and measures, provides more data about the welfare implications of this practice.

Comparison of analgesic techniques for antler removal in halothane-anaesthetized red deer (Cervus elaphus): electroencephalographic responses

OBJECTIVE

To provide evidence for an analgesic effect of antler pedicle compression or lidocaine 'ring block' by comparing changes in median and spectral edge frequencies and total electroencephalographic (EEG) power during the application of each technique followed by antler removal.

ANIMALS

Twenty-nine 2-year-old red deer (Cervus elaphus) stags weighing 106-131 kg each were used in this study. Stags were carrying immature growing antler suitable for commercial harvest.

MATERIALS AND METHODS

Anaesthesia was induced using propofol (8.25 +/- 1.28 mg kg(-1)) and ketamine (2.18 +/- 0.15 mg kg(-1)) and maintained with halothane in oxygen. End-tidal halothane (Fe'HAL), expired CO(2) tension (Pe'CO(2)), SpO(2), EEG, ECG, and direct arterial blood pressures were recorded continuously. Respiratory rate and somatic responses were recorded at specific time points. After stabilization of anaesthesia (Fe'HAL was approximately 0.8%) baseline data were recorded. Stags were randomly allocated to one of three treatment groups; control, local anaesthesia, or compression band. One antler was removed 4 minutes after the application of treatment. Electroencephalographic responses to application of treatment and antler removal were analysed using area under the curve (AUC) analysis. Mean AUC was compared between groups using anova, and when significant differences were found, groups were compared post hoc with two-tailed t-tests. Significance levels were set at p </= 0.05.

RESULTS

Median frequency (F(50)) was increased during antler removal in the control group and during both application and antler removal in the compression group. In the lidocaine group, F(50) was decreased during both application and antler removal. Spectral edge frequency (F(95)) was increased during the antler removal period in the control group and during both application and antler removal in the compression group. In the lidocaine group, F(95) was decreased in the application time period. Total EEG power (P(tot)) was decreased in the removal period in the control group. In the compression group, P(tot) was decreased in the removal period. In the lidocaine group, P(tot) was decreased in the application period. There were no significant differences in EEG variables between antler removal in the control group and application of compression (p = 0.19-0.96).

CONCLUSIONS

These data suggest that lidocaine 'ring block' of the antler pedicle provides adequate analgesia for velvet antler removal. The use of antler pedicle compression bands represents a noxious stimulus in its own right and is not as protective as lidocaine 'ring block' against the noxious stimulus of surgical antler removal.

CLINICAL RELEVANCE

Compression of the antler pedicle has been recommended as an alternative to lidocaine 'ring block' for velvet antler removal. The results of this study suggest that antler pedicle compression is noxious. In addition, antler pedicle compression offers less effective analgesia than lidocaine 'ring block'.

Comparison of analgesic techniques for antler removal in halothane-anaesthetized red deer (Cervus elaphus): cardiovascular and somatic responses

OBJECTIVE

To compare changes in heart rate and arterial pressures resulting from compression of the antler pedicle or lidocaine 'ring block' and during subsequent antler removal during minimal halothane anaesthesia.

ANIMALS

Twenty-nine 2-year-old red deer (Cervus elaphus) stags, weighing 106-131 kg and carrying immature growing antler suitable for commercial harvest were studied.

MATERIALS AND METHODS

Anaesthesia was induced using intravenous propofol (median dose 8.0 mg kg(-1), range 5.2-11.0) and ketamine (median dose 2.2 mg kg(-1), range 1.9-2.4) and maintained using halothane in oxygen. End-tidal halothane concentration (Fe'HAL) end-tidal CO(2) tension (Pe'CO(2)), SpO(2), EEG, ECG, and direct systolic (SAP) mean (MAP) and diastolic (DAP) arterial pressures were recorded continuously. Respiratory rate and somatic responses were recorded. Baseline data were recorded once anaesthesia (Fe'HAL approximately 0.8%) was stable. Stags were randomly allocated to control, lidocaine 'ring block' or compression band treatment groups. One antler was removed 4 minutes after treatment. Cardiovascular responses to the application of analgesia and antler removal were analysed using a general estimates equation for repeated measures or area under the curve (AUC) analysis. Mean AUC was compared between groups using anova, and when significant differences were found, groups were compared post hoc with two-tailed t-tests. Somatic response data were compared with Fisher's exact chi-square test. A value of p < 0.05 was considered significant.

RESULTS

Heart rate fell during observations in all groups with no significant differences between groups. Arterial pressures in the control and lidocaine groups during treatment and removal were not different from baseline values or from each other. Compression group pressures were significantly higher than baseline during both treatment and removal. Compression group DAP and MAP were significantly higher after antler removal than during treatment. In control and lidocaine groups, the AUC for SAP, DAP, and MAP over the combined baseline, treatment, and removal period did not differ. The compression group AUC for DAP and MAP were significantly greater over the experimental period than both the lidocaine group and control groups. Somatic responses occurred in one animal at lidocaine injection and three at compression application. Somatic responses occurred in eight control animals and two in the compression group at antler removal. More animals responded to antler removal in the control group than in the compression (p = 0.015) or lidocaine (p < 0.001) groups.

CONCLUSIONS

Compression of the antler pedicle appears to be noxious. Pedicular compression is a less effective analgesic technique for antler removal compared to 'ring blocks' with lidocaine.

CLINICAL RELEVANCE

This study suggests that lidocaine 'ring blocks' are the current technique of choice for antler removal in deer.

Advances in health and welfare of farmed deer in New Zealand

New Zealand has lead the world in pastoral farming of red, wapiti and fallow deer since this was first sanctioned in 1970. Among technological advances in deer production systems have been milestones in our understanding of deer health and welfare in an intensive pastoral farming environment, contributed by the combined efforts of veterinary practitioners, producers and researchers. These advances have impacted enormously on the health and wellbeing of New Zealand's farmed deer population, and contribute significantly to the success of deer production systems and the sustainability of the industry's international markets and reputation. These activities have brought local and international distinction upon the veterinary profession in New Zealand, by demonstrating innovation and initiative in establishing a new discipline of veterinary endeavor. This paper briefly reviews the important milestones in veterinary knowledge of capture-stress management, deer mortalities, the key disease syndromes of tuberculosis, yersiniosis, malignant catarrhal fever (MCF), internal parasites, trace elements and miscellaneous conditions, and selected animal welfare issues.

Evaluation of techniques for lignocaine hydrochloride analgesia of the velvet antler of adult stags

AIM

To evaluate the effectiveness of various routes of administration and doses of local anaesthetic (LA) to provide analgesia of the velvet antler of adult stags.

METHODS

In Experiment 1, antlers from 50 red deer stags, >or=2-years-old were allocated to 1 of 4 treatment groups (n = 25 antlers/group) to receive injections with 2% lignocaine hydrochloride as follows: High-dose (1 ml/cm pedicle circumference) or Low-dose ring-block (0.4 ml/cm pedicle circumference) or; High-site or Low-site regional nerve block (5 ml per site, both of which included the auriculopalpebral nerve). An electrical stimulus was applied before application of LA and then each min for up to 4 min after LA injection. If no response was observed, analgesia was tested with a saw cut. If no response occurred, the antler was cut at that time. If the animal responded, a further wait time was applied until 4 min had elapsed, at which time observations ceased. In Experiment 2, 10 primary and 50 re-growth antlers were given a High-dose ring-block and tested with a saw cut after 1 min (n = 30) or 2 min (n = 30). If no response occurred, the antler was removed. If a response occurred, further 1-min wait periods were applied.

RESULTS

In the High-dose ring-block and High-site nerve-block groups, 24/25 and 21/25 antlers were removed without response by 2 min, compared with 20/25 and 15/25 antlers in the Low-dose ring-block and Low-site nerve-block groups, respectively. The High-dose ring-block provided more effective analgesia after 3 min than the Low-dose ring-block, as assessed by the number of stags that did not respond to the electrical stimulus (p = 0.008), or subsequent antler removal (p = 0.050). The numbers of antlers removed without response after 1 or 2 min were greater using the High-site nerve-block than the Low-site nerve-block (p = 0.002 and p = 0.037, respectively). In all but the High-dose ring-block group, at least 1 stag required further LA after 4 min, before antler could be humanely removed. In Experiment 2, stags reacted to a saw-cut test on 6/30 antlers, 1 min after a High-dose ring-block, compared with 1/30 antlers after 2 min (p = 0.051).

CONCLUSION

The High-dose ring-block produced the most effective and rapid analgesia.

CLINICAL RELEVANCE

A High-dose ring-block with a 2-min wait period should be the preferred method for achieving local analgesia for velvet antler removal.