To determine the efficacy and duration of effect for liposomal bupivacaine following perineural administration to the medial and lateral palmar digital nerves of horses.
9 nonlame mares.
For each horse, 2 mL of liposomal bupivacaine (13.3 mg/mL; total dose, 53.2 mg or approx 0.11 mg/kg) or sterile saline (0.9% NaCl) solution was injected adjacent to the medial and lateral palmar digital nerves at the level of the distal aspect of the proximal sesamoid bones of a randomly selected forelimb. Twenty-one days later, the opposite treatment was administered in the contralateral forelimb. A digital algometer was used to measure the mechanical nociceptive threshold (MNT) immediately before and at predetermined times for 48 hours after injection of each treatment. The mean MNT was compared between the 2 treatments at each measurement time.
The mean MNT for the liposomal bupivacaine-treated limbs was significantly greater (ie, the limb was less sensitive) than that for the saline-treated limbs between 30 minutes and 4 hours after treatment injection. Following liposomal bupivacaine administration, 1 horse developed mild swelling at the injection sites that resolved without treatment within 24 hours. No other adverse effects were observed.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that liposomal bupivacaine is another option for perineural anesthesia in horses. Further research is necessary to determine the optimal dose and better elucidate the duration of effect for the drug when used for palmar digital nerve blocks in horses.
To determine whether palmar digital nerve (PDN) blockade in horses with a combination of dexmedetomidine and mepivacaine would block the response to mechanical force applied to the digit longer than would anesthetizing these nerves with mepivacaine alone or dexmedetomidine alone.
8 mares with no signs of lameness.
In a randomized, crossover, blinded, experimental study, both PDNs of the same forelimb of each horse were anesthetized by perineural injection with either 30 mg mepivacaine alone, 250 µg of dexmedetomidine alone, or 30 mg mepivacaine combined with 250 µg of dexmedetomidine. Each horse received each treatment, and treatments were administered ≥ 2 weeks apart. The mechanical nociceptive threshold was measured at a region between the heel bulbs with the use of a digital force gauge before (baseline) and at 15-minute intervals after treatment.
The mean duration of sensory blockade of the digit was 2-fold longer when a combination of mepivacaine and dexmedetomidine was administered (371 minutes), compared with when mepivacaine alone was administered (186 minutes). Treatment with dexmedetomidine alone did not change the mechanical nociceptive threshold substantially from baseline and resulted in no clinical signs of sedation.
Results indicated that relief from digital pain provided by perineural treatment with mepivacaine for PDN blockade can be extended by adding dexmedetomidine to the injectate.