Diagnostic Analgesia

Authors: J. Schumacher, M. C. Schramme, J. Schumacher and F. J. DeGraves
Journal: Equine Veterinary Education

Analgesia usually occurs within 5 min after administration of local anaesthetic solution into joints or around nerves in the distal portion of the limb. Gait should be assessed within 10 min after diagnostic regional analgesia of the distal portion of the limb because rapid diffusion of anaesthetic solution can result in anaesthesia of other nerve branches, thus confusing results of the examination.

Authors: W. Schneeweiss, A. Puggioni and F. David
Journal: Equine Veterinary Journal

Summary

Reasons for performing study: Diagnosis and treatment of pathologies involving synovial structures in the shoulder region are technically difficult. Ultrasound-guided (UG) injection techniques have been shown to be highly accurate, safe and reliable for various structures in human and equine patients.

Objectives: To develop easy-to-use and reliable UG injection techniques for the infraspinatus bursa (IB), bicipital bursa (BB) and scapulohumeral joint (SHJ) and to compare them with conventional ‘blind’ methods.

Authors: A. Nagy, G. Bodó and S. J. Dyson
Journal: Equine Veterinary Journal

Summary

Reasons for performing study: There is limited information on potential diffusion of local anaesthetic solution after various diagnostic analgesic techniques of the proximal metacarpal region.

Objective: To document potential distribution of local anaesthetic solution following 4 techniques used for diagnostic analgesia of the proximal metacarpal region.

Authors: John Schumacher, Jim Schumacher and R. Wilhite
Journal: Equine Veterinary Journal

Summary

Reasons for performing study: Clinical experiences indicate that centesis of the lateral compartment of the femorotibial joint is often unsuccessful.

Objective: To determine the accuracy of 2 published and 2 unpublished techniques of centesis of the lateral compartment of the femorotibial joint.

Authors: S. S. Down, G. A. Munroe, R. C. Murray
Journal: Equine Veterinary Education

A cranial technique for entry of the medial femorotibial (MFT) joint in the horse was validated. It was hypothesised that the frequency of correct placement into the MFT joint using the described cranial technique would be similar to using a standard medial approach. Twenty-four limbs from 15 horses were injected with a latex mixture. Limbs with stifle joint effusion and/or known stifle pathology were grouped separately to those without.

Authors: Matthieu Cousty DVM, IPSAV, Charlotte Firidolfi Student, Olivier Geffroy DVM, Diplomate ECVS, Florent David DVM, IPSAV, DES, MSc, Diplomate ACVS & ECVS
Journal: Veterinary Surgery

Objective: To compare ultrasound-guided lateral and medial approaches for periarticular injections of the thoracolumbar intervertebral facet joints (IFJ).

Study Design: Experimental cadaveric study.

Sample Population: Adult equine cadavers (n=4).

Authors: Ferenc Tóth DVM, PhD, Jim Schumacher DVM, Diplomate ACVS, Michael Schramme DVM, PhD, Diplomate ECVS, Silke Hecht Dr med vet, Diplomate ACVR & ECVDI
Journal: Veterinary Surgery

Objective: To describe the anatomic features of the equine trochanteric bursa and to evaluate 4 techniques for bursa centesis.

Study Design: Prospective, randomized design.

Animals: Equine cadavers (n=2) and 20 live horses.

Authors: L. A. B. Poore, MA, VetMB, MRCVS, K. L. Lambert, BSc, D. J. Shaw, BSc, PhD and M. P. Weaver, BVMS, PhD, DrMedVet, DVR, MRCVS
Journal: Veterinary Record

The efficacy of three methods of injecting the equine proximal interphalangeal (pastern) joint was compared using cadaver limbs. Five veterinary students without prior experience attempted to inject an aqueous radiographic contrast medium into the joint using five limbs for each technique. The number of attempts was recorded and successful injection of the joint was confirmed by the presence of intra-articular contrast on radiographic examination. Levels of accuracy for the dorsal, dorsolateral and palmaroproximal approaches were 32, 48 and 36 per cent, respectively.

Authors: A. NAGY, G. BODÒ, S. J. DYSON, F. COMPOSTELLA, A. R. S. BARR
Journal: Equine Veterinary Journal

Reasons for performing study: Evidence-based information is limited on distribution of local anaesthetic solution following perineural analgesia of the palmar (Pa) and palmar metacarpal (PaM) nerves in the distal aspect of the metacarpal (Mc) region (‘low 4-point nerve block’).

Objectives: To demonstrate the potential distribution of local anaesthetic solution after a low 4-point nerve block using a radiographic contrast model.

Authors: Nagy, A.; Bodo, G.; Dyson, S.J.; Szabo, F.; Barr, A.R.S.
Journal: Equine Veterinary Journal

Reasons for performing study: Proximal diffusion of local anaesthetic solution after perineural anaesthesia may lead to the desensitisation of structures other than those intended. However, there is no evidence-based study demonstrating the potential distribution and diffusion of local anaesthetic solution after perineural analgesia in the distal limb.

Objective: To document the potential diffusion of local anaesthetic solution using a radiopaque contrast model and to evaluate the influence of walking compared with confinement in a stable after injection.