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Osborne C, Elce YA, Byrant B, Meehan-Howard L. Effects of intra-articular anesthesia of the tarsometatarsal joint on skin sensation of the distal limb in horses. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2024; 65:808-812. [PMID: 39091475 PMCID: PMC11265819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Objective To determine with mechanical nociceptive threshold (MNT) testing whether distal limb skin sensation is affected by intra-articular anesthesia of the tarsometatarsal joint (TMTJ). Animals and procedure This was a prospective cohort study. Ten client-owned horses that had intra-articular TMTJ anesthesia were included in the study. The MNT was measured at 6 sites on the distal limb at 3 time points: before anesthesia (T0) and at 10 min (T10) and 30 min (T30) post-injection. Linear mixed-model analyses were done, with the significance level set at P < 0.05. Results There was an increase in MNT (P = 0.001) across combined testing points between T0 and T30, indicating loss of skin sensation in the distal limb 30 min after TMTJ anesthesia. Regarding individual MNT sites, there were increases at the lateral proximal sesamoid bone (P = 0.002) and dorsal coronary band (P = 0.037) at T30 compared to T0. Conclusion Intra-articular anesthesia of the TMTJ significantly increased the combined MNT of the skin of the distal limb at 30 min, indicating decreased skin sensation. Clinical relevance Diagnostic anesthesia of the distal hind limb should be performed before TMTJ block. However, if patient compliance prevents this, lameness evaluation 10 min after blocking may enhance the reliability of interpretation.
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Affiliation(s)
- Craig Osborne
- Langford Vets Equine Hospital, Langford, Bristol BS40 5DU, UK
| | - Yvonne A Elce
- Langford Vets Equine Hospital, Langford, Bristol BS40 5DU, UK
| | - Beth Byrant
- Langford Vets Equine Hospital, Langford, Bristol BS40 5DU, UK
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Pearce DJ, Raffetto J, Vallance SA. Transient Horner's syndrome in horses following cervical plexus local anesthesia. Vet Surg 2024; 53:642-647. [PMID: 38010125 DOI: 10.1111/vsu.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/10/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To report the development of transient Horner's syndrome in horses following local anesthesia of the cervical plexus. ANIMALS A total of 37 horses. STUDY DESIGN Observational retrospective short case series. METHODS Medical records of cases undergoing ultrasound-guided cervical plexus anesthesia for standing prosthetic laryngoplasty at a single referral institution were evaluated (2019-2020). RESULTS Five of 37 horses (14%) developed transient signs of Horner's syndrome postoperatively. Obvious clinical signs began 2 to 5 h following local anesthesia and persisted for two to 4 h. Profuse unilateral sweating of the head and upper neck was the most apparent clinical sign. CONCLUSION Transient clinical signs of Horner's syndrome were seen following unilateral local anesthesia of the cervical plexus. Long-term adverse sequelae were not observed.
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Affiliation(s)
- Duncan J Pearce
- Equine Centre, University of Melbourne Faculty of Sciences, Werribee, Victoria, Australia
| | - Jennifer Raffetto
- Equine Centre, University of Melbourne Faculty of Sciences, Werribee, Victoria, Australia
| | - Stuart A Vallance
- Advantage Equine Veterinary Practice, Ascot Vale, Victoria, Australia
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3
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Webster A, Pezzanite L, Hendrickson D, Griffenhagen G. Review of intra-articular local anaesthetic administration in horses: Clinical indications, cytotoxicity, and outcomes. Equine Vet J 2023. [PMID: 37940372 DOI: 10.1111/evj.14027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Equine practitioners frequently inject local anaesthetics (LA) intra-articularly in both diagnosis of lameness and for pain management intra- or post-operatively with synovial endoscopy. Recent reviews of the human and veterinary literature support the concept that chondrotoxicity of LA on joint tissues depends on the type of drug, dose administered, and duration of exposure. The purpose of this review is to summarise the current literature describing intra-articular local anaesthetic use, including both in vitro and in vivo studies, and to draw some comparisons to literature from other species where potential toxicity and duration of effect have been evaluated with the goal of advancing the field's understanding of intra-articular local anaesthetic use in horses, and indicating future directions for the field. The aggregate data available from all species, while generally sparse for horses, indicate that LA are rapidly cleared from the synovial fluid after injection, often within 30 min. In vitro data strongly suggest that lidocaine and bupivacaine are likely more chondrotoxic than other LA, although to what extent is still unknown, and cytotoxicity of LA may be mitigated through concurrent injection with HA, PRP, and drug combinations including nonsteroidal anti-inflammatories and opioids. The current body of in vitro research is not reflective of the in vivo environment, and further in vitro work, if performed, should focus on mimicking the native joint environment, utilising PK data and joint/injection volumes to replicate the native environment more accurately within the joint and the expected exposures to LA.
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Affiliation(s)
- Aaron Webster
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Dean Hendrickson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Gregg Griffenhagen
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Bolz NM, Sánchez-Andrade JS, Torgerson PR, Bischofberger AS. Diagnostic Performance of Multi-Detector Computed Tomography Arthrography and 3-Tesla Magnetic Resonance Imaging to Diagnose Experimentally Created Articular Cartilage Lesions in Equine Cadaver Stifles. Animals (Basel) 2023; 13:2304. [PMID: 37508081 PMCID: PMC10376593 DOI: 10.3390/ani13142304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/09/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The purpose of the study was to determine the diagnostic performance of computed tomographic arthrography (CTA) and 3-Tesla magnetic resonance imaging (MRI) for detecting artificial cartilage lesions in equine femorotibial and femoropatellar joints. METHODS A total of 79 cartilage defects were created arthroscopically in 15 cadaver stifles from adult horses in eight different locations. In addition, 68 sites served as negative controls. MRI and CTA (80-160 mL iodinated contrast media at 87.5 mg/mL per joint) studies were obtained and evaluated by a radiologist unaware of the lesion distribution. The stifles were macroscopically evaluated, and lesion surface area, depth, and volume were determined. The sensitivity and specificity of MRI and CTA were calculated and compared between modalities. RESULTS The sensitivity values of CTA (53%) and MRI (66%) were not significantly different (p = 0.09). However, the specificity of CTA (66%) was significantly greater compared to MRI (52%) (p = 0.04). The mean lesion surface area was 11 mm2 (range: 2-54 mm2). Greater lesion surface area resulted in greater odds of lesion detection with CTA but not with MRI. CONCLUSIONS CTA achieved a similar diagnostic performance compared to high-field MRI in detecting small experimental cartilage lesions. Despite this, CTA showed a higher specificity than MRI, thus making CTA more accurate in diagnosing normal cartilage. Small lesion size was a discriminating factor for lesion detection. In a clinical setting, CTA may be preferred over MRI due to higher availability and easier image acquisition.
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Affiliation(s)
- Nico M Bolz
- Equine Hospital, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | | | - Paul R Torgerson
- Section of Veterinary Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Andrea S Bischofberger
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Quam V, Yardley J, Quam M, Paz C, Belknap J. Cryotherapy provides transient analgesia in an induced lameness model in horses. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2021; 62:834-838. [PMID: 34341594 PMCID: PMC8281941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The analgesic effect of cryotherapy in an induced lameness model was evaluated. Lameness was induced with solar pressure from a custom-made shoe in a 10-horse, cross-over study. The degree of lameness was recorded with a commercial non-invasive inertial sensor. The distal limbs were maintained in an ice and water slurry (cryotherapy) or at ambient temperature (control) for 1 hour. Lameness was assessed serially over the following hour. Lameness at each time point was compared to the baseline induced lameness, within and between groups. Lameness had improved significantly in all horses 5 minutes after treatment but remained improved 10 minutes after treatment for the cryotherapy group only. Fifteen minutes after treatment, lameness in the cryotherapy group was improved relative to the control. Cryotherapy produced moderate, transient analgesia. Additional research is required to determine if altering the method, duration, or temperature of cryotherapy, as well as the targeted pathology and anatomy, alters the analgesic effect.
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Affiliation(s)
- Vivian Quam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, Ohio 43210, USA (V Quam, Yardley, Belknap); Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå 901 87, Sweden (M Quam); Department of Veterinary Clinics and Surgery, College of Veterinary, Universidade Federal de Minas Gerais (UFMG), 6627 Av. Antônio Carlos, Belo Horizonte, Minas Gerais 31270-901 Brazil (Paz)
| | - Jonathan Yardley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, Ohio 43210, USA (V Quam, Yardley, Belknap); Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå 901 87, Sweden (M Quam); Department of Veterinary Clinics and Surgery, College of Veterinary, Universidade Federal de Minas Gerais (UFMG), 6627 Av. Antônio Carlos, Belo Horizonte, Minas Gerais 31270-901 Brazil (Paz)
| | - Mikkel Quam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, Ohio 43210, USA (V Quam, Yardley, Belknap); Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå 901 87, Sweden (M Quam); Department of Veterinary Clinics and Surgery, College of Veterinary, Universidade Federal de Minas Gerais (UFMG), 6627 Av. Antônio Carlos, Belo Horizonte, Minas Gerais 31270-901 Brazil (Paz)
| | - Cahuê Paz
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, Ohio 43210, USA (V Quam, Yardley, Belknap); Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå 901 87, Sweden (M Quam); Department of Veterinary Clinics and Surgery, College of Veterinary, Universidade Federal de Minas Gerais (UFMG), 6627 Av. Antônio Carlos, Belo Horizonte, Minas Gerais 31270-901 Brazil (Paz)
| | - James Belknap
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, Ohio 43210, USA (V Quam, Yardley, Belknap); Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå 901 87, Sweden (M Quam); Department of Veterinary Clinics and Surgery, College of Veterinary, Universidade Federal de Minas Gerais (UFMG), 6627 Av. Antônio Carlos, Belo Horizonte, Minas Gerais 31270-901 Brazil (Paz)
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Nagy A. Clinical insights: Lameness diagnosis in sports horses. Equine Vet J 2020; 52:775-778. [PMID: 33017491 DOI: 10.1111/evj.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 05/30/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Annamaria Nagy
- Equine Department and Clinic, University of Veterinary Medicine, Dóra Major, Üllő, Hungary
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Miagkoff L, Bonilla AG. Desensitisation of the distal forelimb following intrathecal anaesthesia of the carpal sheath in horses. Equine Vet J 2020; 53:167-176. [PMID: 32301518 DOI: 10.1111/evj.13269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The effect of intrathecal anaesthesia of the carpal sheath on distal forelimb sensitivity in horses remains unknown. OBJECTIVES To assess the effect of carpal sheath anaesthesia on skin sensitivity of the distal forelimb and to determine potential locations for desensitisation of palmar nerves. STUDY DESIGN In vivo experimental and descriptive anatomical studies. METHODS Mepivacaine hydrochloride 2% (0.6 mg/kg) was injected unilaterally in the carpal sheath of 8 horses. Mechanical nociception of the distal forelimb was measured with a dynamometer and compared with the control limb at t0, t15, t30, t60, t90, t120 and t180 minutes . Additionally, the carpal sheath of 10 pairs of cadaveric limbs was injected with latex and potential locations for anaesthetic diffusion to the neighbouring nerves were identified during longitudinal dissection (one limb) and in 3-cm-thick transverse cuts (opposite limb). RESULTS Six of 8 horses (75%) were completely desensitised at the level of both heel bulbs. Anaesthetic injection was not smooth in the 2 horses without desensitisation. Desensitisation started between 30 and 60 minutes in 67% of desensitised heel bulbs (8/12), and 50% (6/12) of them were still completely desensitised at 180 minutes. Cadaveric specimens revealed close proximity between the sheath and the medial palmar nerve as it travels inside the mesotenon of the digital flexor tendons in the carpal region and with both palmar nerves at the proximal metacarpal region. MAIN LIMITATIONS Skin mechanical nociception does not necessarily correlate with deep pain but remains the main clinical tool used by practitioners to assess distal limb anaesthesia. CONCLUSIONS Intrathecal anaesthesia of the carpal sheath led to distal limb skin desensitisation through diffusion to the palmar nerves at 2 possible locations. Carpal sheath anaesthesia should be interpreted within 15 minutes following injection and anaesthetic blocks distal to the carpus should be delayed for more than 3 hours following carpal sheath anaesthesia.
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Affiliation(s)
- Ludovic Miagkoff
- Department of Clinical Sciences, College of Veterinary Medicine, Université de Montréal, St. Hyacinthe, Quebec, Canada
| | - Alvaro G Bonilla
- Department of Clinical Sciences, College of Veterinary Medicine, Université de Montréal, St. Hyacinthe, Quebec, Canada
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Clements PE, Handel I, McKane SA, Coomer RP. An investigation into the association between plantar distal phalanx angle and hindlimb lameness in a
UK
population of horses. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P. E. Clements
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
| | - I. Handel
- Royal (Dick) School of Veterinary Studies Division of Veterinary Clinical Studies Hospital for Small Animals Easter Bush Veterinary Centre The University of Edinburgh Roslin Midlothian UK
| | - S. A. McKane
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
| | - R. P. Coomer
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
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