Equis ISSN 2398-2977

Hindlimb: perineural analgesia

Synonym(s): Nerve block

Contributor(s): Dennis R Gieser, Graham Munroe, Vetstream Ltd, Enzo Vettorato

Introduction

  • By removing sensitization to source of pain, lameness is abolished or lessened.
  • technique is conducted sequentially working from distal to proximal.

Uses

  • Adjunct to lameness diagnostic work-up and post-operative analgesia.

Advantages

  • Systematic procedure.
  • Minimally invasive.
  • Good regional localization of source of pain.

Disadvantages

  • Response may be inconsistent.
  • Diffusion of anesthetic agent can result in joint block.
  • Some agents more irritant than others, eg lidocaine   Lidocaine  .
  • Mepivacaine   Mepivacaine  is preferred agent.
  • Anesthetic solution irritates tissues and causes a low grade inflammation   →   confounds nuclear imaging techniques for up to 2 weeks.
  • Procedure complicated by fractious horses.

Requirements

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Preparation

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Procedure

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Michou J & Leece E (2012) Sedation and analgesia in the standing horse 2. Local anaesthesia and analgesia techniques. In Pract 34 (10), 578-587 VetMedResource.
  • Nagy A, Bodo G, Dyson S J, Szabo F & Barr A R S (2009) Diffusion of contrast medium after perineural injection of the palmar nerves: An in vivo and in vitro study. Equine Vet J 41 (4), 379-383 PubMed.
  • Hendrickson D A & Nixon A J (1992) A lateral approach for synovial fluid aspiration and joint injection of the femoropatellar joint of the horse. Equine Vet J 24, 399-401 PubMed.

Other sources of information

  • Hughes T K, Eliashar E & Smith R K W (2006)In-vitro Evaluation of a Single Injection technique for Diagnostic Analgesia of the Proximal Suspensory Ligament.In:ECVS Seville, Spain 2006 - Proceedings. Eds: Schramme M, Tremaine H, Walmsley J & Houlton J. ECVS, Zurich. pp 71-73.
  • Dyson S (2006)Critical Evaluation and Review of Local Anaesthetic techniques for the Upper Hindlimb.In:Handbook of Presentations & Free Communications. BEVA Congress 2006. BEVA, Fordham, Cambs. pp 33-34.
  • Redding W R (2006)Critical Evaluation and Review of Local Anaesthetic techniques for the Lower Limb.In:Handbook of Presentations & Free Communications. BEVA Congress 2006. BEVA, Fordham, Cambs. pp 28-30.
  • Torre F (2004)How to Perform and Interpret Hind Leg Nerve Blocks in a Fractious Horse.In:Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 39.
  • Stashak T S (2002) Perineural Anesthesia The Hindlimb.In:Adams Lameness in Horses. 5th edn. Lippincott, Williams & Wilkins, Baltimore. pp 165-167.


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