Cardiopulmonary effects of epidurally administered xylazine in the horse

This study was designed to determine whether the epidural administration of an alpha2 agonist, xylazine, would produce measurable changes in arterial blood pressure, electrocardiographic (ECG) activity and arterial blood gas values in horses. Six horses were given each of four treatments: epidural xylazine, intravenous xylazine, epidural lidocaine and epidural saline. A carotid artery catheter was used to measure arterial blood pressure and to collect samples for blood gas analysis before treatment and at intervals post treatment. Heart rate, arterial pressures, ECG activity and respiratory rate were recorded at the same intervals. No significant changes were recorded between time intervals or between individual treatments. It was concluded that this method of xylazine administration to horses produced potent caudal analgesia without measurable cardiopulmonary effects.     

Comparison of Analgesic Effects of Caudal Epidural 0.25% Bupivacaine with Bupivacaine Plus Morphine or Bupivacaine Plus Ketamine for Analgesia in Conscious Horses

The aim of this study was to compare the effects of caudal epidural bupivacaine alone (BP), bupivacaine plus morphine (BPMP), and bupivacaine plus ketamine (BPKE) for perineal analgesia in horses. Each of the six saddle horses received a caudal epidural catheter and underwent 3 treatments: BP, 0.25% (0.04 mg/kg) bupivacaine hydrochloride without epinephrine; BPMP, 0.02 mg/kg of bupivacaine combined with 0.1 mg/kg of morphine-preservative free; and BPKE, 0.02 mg/kg of bupivacaine combined with 0.5 mg/kg of ketamine. The order of treatments was randomized. The cardiovascular system, respiratory rate, quality of analgesia, sedation, and motor blockade were assessed before drug administration (baseline), at 5, 10, 15, and 30 minutes, and every 30 minutes thereafter until loss of analgesia. The median time to onset of analgesia was 5 minutes after BP treatment, faster than after BPKE or BPMP treatments, which were 10 minutes and 15 minutes, respectively (P < .05). The BPMP treatment produced analgesia (315 minutes) for a longer duration than BP treatment (210 minutes) or BPKE treatment (240 minutes), in the regions of the tail, perineum, and upper hind limb in horses. All treatments presented mild sedation or motor blockade. There were minimal effects on the cardiovascular system and respiratory rate. BPMP may be preferable to a high dose of BP or BPKE. Caudal epidural BPMP can be an appropriate choice for regional perineal analgesia in horses.     

Analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares.

OBJECTIVE: To determine the analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares. ANIMALS: 7 healthy mares. Procedure: Each mare received meperidine (5%; 0.8 mg/kg of body weight) or saline (0.9% NaCl) solution via caudal epidural injection on 2 occasions. At least 2 weeks elapsed between treatments. Degree of analgesia in response to noxious electrical, thermal, and skin and muscle prick stimuli was determined before and for 5 hours after treatment. In addition, cardiovascular and respiratory variables were measured and degree of sedation (head position) and ataxia (pelvic limb position) evaluated. RESULTS: Caudal epidural administration of meperidine induced bilateral analgesia extending from the. coccygeal to S1 dermatomes in standing mares; degree of sedation and ataxia was minimal. Mean (+/- SD) onset of analgesia was 12 +/- 4 minutes after meperidine administration, and duration of analgesia ranged from 240 minutes to the entire 300-minute testing period. Heart and respiratory rates, rectal temperature, arterial blood pressures, Hct, PaO2, PaCO2, pHa, total solids and bicarbonate concentrations, and base excess were not significantly different from baseline values after caudal epidural administration of either meperidine or saline solution. CONCLUSIONS AND CLINICAL RELEVANCE: Caudal epidural administration of meperidine induced prolonged perineal analgesia in healthy mares. Degree of sedation and ataxia was minimal, and adverse cardiorespiratory effects were not detected. Meperidine may be a useful agent for induction of caudal epidural analgesia in mares undergoing prolonged diagnostic, obstetric, or surgical procedures in the anal and perineal regions.     

Pharmacokinetics of Tramadol after Epidural Administration in Horses

Tramadol is a centrally acting analgesic structurally related to codeine and morphine. The aim of the present study was to evaluate the pharmacokinetic of tramadol and its major metabolites after caudal epidural administration in the horse. Six gelding male adult horses were assigned to receive epidural administration of tramadol at 2 mg/kg. Plasma substances detection was achieved using a HPLC-FL method. Tramadol was detectable after 5 minutes up to 8 hours after epidural administration. Metabolites plasma concentrations were found under the limit of quantification of the method; however negligible amounts of M2 was detected from 30 min up to 1 hour in three subjects. In conclusion, this study shows that tramadol administered by caudal route in horses produces plasma concentrations within the extrapolated therapeutic range from humans for sufficient time to provide analgesia. Further study of the drug's safety and efficacy for the treatment of pain in horses is warranted.     

Sedative and analgesic effects of intravenous xylazine and tramadol on horses

This study was performed to evaluate the sedative and analgesic effects of xylazine (X) and tramadol (T) intravenously (IV) administered to horses. Six thoroughbred saddle horses each received X (1.0 mg/kg), T (2.0 mg/kg), and a combination of XT (1.0 and 2.0 mg/kg, respectively) IV. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), indirect arterial pressure (IAP), capillary refill time (CRT), sedation, and analgesia (using electrical stimulation and pinprick) were measured before and after drug administration. HR and RR significantly decreased from basal values with X and XT treatments, and significantly increased with T treatment (p < 0.05). RT and IAP also significantly increased with T treatment (p < 0.05). CRT did not change significantly with any treatments. The onset of sedation and analgesia were approximately 5 min after both X and XT treatments; however, the XT combination produced a longer duration of sedation and analgesia than X alone. Two horses in the XT treatment group displayed excited transient behavior within 5 min of drug administration. The results suggest that the XT combination is useful for sedation and analgesia in horses. However, careful monitoring for excited behavior shortly after administration is recommended.     

Epidural administration of tiletamine/zolazepam in horses

Objectives To evaluate the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses. Study design Prospective, double‐blind, randomized experimental study. Animals Five adult, healthy horses aged 10–16 years and weighing (mean ± SD) 400 ± 98 kg. Methods The horses were sedated with 1.0 mg kg^?1 intravenous (IV) xylazine, and an epidural catheter was placed into the first intercoccygeal intervertebral space. After a 48‐hour resting period, epidural tiletamine/zolazepam, 0.5 mg kg^?1 (treatment I) or 1.0 mg kg^?1 (treatment II), diluted up to 5 mL in sterile water, was administered with a 1‐week interval between the treatments. Heart rate, respiratory rate, arterial blood pressure, and sedation were evaluated. In order to evaluate the respiratory effects, blood from the carotid artery was withdrawn at time 0 (baseline), and then after 60 and 240 minutes. Analgesia was evaluated by applying a noxious stimulus with blunt‐tipped forceps on the perineal region, and graded as complete, moderate, or absent. Data were collected before tiletamine/zolazepam administration and at 15‐minute intervals for 120 minutes, and 4 hours after tiletamine/zolazepam administration. Data were analyzed with anova and Bonferroni's test with p < 0.05. Results The results showed no significant difference between treatments in cardiovascular and respiratory measurements. Sedation was observed with both doses, and it was significantly different from baseline at 60, 75, and 90 minutes in treatment II. Moderate analgesia and locomotor ataxia were observed with both the treatments. Conclusions and clinical relevance The results suggest that caudal epidural 0.5 and 1.0 mg kg^?1 tiletamine/zolazepam increases the threshold to pressure stimulation in the perineal region in horses. The use of epidural tiletamine/zolazepam could be indicated for short‐term moderate epidural analgesia. There are no studies examining spinal toxicity of Telazol, and further studies are necessary before recommending clinical use of this technique.     

Perineal analgesia and hemodynamic effects of the epidural administration of meperidine or hyperbaric bupivacaine in conscious horses

Epidural administration of bupivacaine and meperidine produces analgesia in several animal species and in humans. A prospective randomized study was conducted in 18 healthy horses to compare the effect of these 2 drugs administered by the epidural route. Animals were divided into 3 treatment groups of 6 animals each. All drugs were injected by the epidural route in all animals between the 1st and 2nd coccygeal vertebrae. Treatment 1 (BUP)--0.06 mg/kg of body weight of 0.5% hyperbaric bupivacaine; treatment 2 (MEP)--0.6 mg/kg of body weight of 5% meperidine; treatment 3 (SS)--0.9% saline solution (control group). Heart rate, arterial pressure, respiratory rate, rectal temperature, analgesia, sedation, and motor-blocking were determined before drug administration (baseline values); at 5, 10, 15, and 30 minutes after drug administration, and then at 30-minute intervals thereafter. Both hyperbaric bupivacaine and meperidine administered epidurally produced complete bilateral perineal analgesia in all horses. The onset of analgesia was 6, s = 2.6 minutes after injection of bupivacaine, as opposed to 9, s = 2 minutes after meperidine. The duration of analgesia was 240, s = 57 minutes for meperidine and 320, s = 30 minutes for bupivacaine. Heart and respiratory rates, arterial pressure, and rectal temperature did not change (P < 0.05) significantly from basal values after the epidural administration of bupivacaine, meperidine, or saline solution. To conclude, both bupivacaine and meperidine induced long-lasting perineal analgesia, with minimal cardiovascular effects. Analgesia was induced faster and lasted longer with bupivacaine.     

Meperidine prolongs lidocaine caudal epidural anaesthesia in the horse

The aim of the study was to evaluate and compare the effects of caudal epidural administration of meperidine (MP), lidocaine (LD), and a combination of the two (MPLD) in six mature saddle horses. Horses were randomly assigned to receive three treatments (MP 0.3 mg/kg; LD 0.2 mg/kg; and MPLD: MP 0.3 mg/kg and LD 0.2 mg/kg), with at least 1 week between treatments. Drugs were injected into the epidural space between the first and second coccygeal areas in conscious standing horses. Analgesia, ataxia, sedation, cardiovascular and respiratory effects, and rectal temperature were recorded at different intervals before (baseline) and after administration. Epidural administration of MPLD resulted in a longer duration of analgesia of the tail, perineum, and upper hind limb regions than did administration of MP or LD alone.     

Pharmacokinetics of lidocaine in serum and milk of mature Holstein cows

The purpose of this study was to evaluate the pharmacokinetics of lidocaine in mature Holstein cows following an inverted L and caudal epidural nerve block. Plasma and milk concentrations were determined using high-performance liquid chromatography assay. Pharmacokinetic parameters were estimated using a noncompartmental method. Following administration via inverted L nerve block, serum T_max was 0.521 ± 0.226 h and serum C_max was 572 ± 207 ng/mL. Serum AUC was 1348 ± 335 ng·h/mL. Apparent serum t_½β was 4.19 ± 1.69 h and MRT was 5.13 ± 2.33 h with clearance uncorrected for the extent of absorption of 2.75 ± 0.68 L/kg/h. The last measurable time of lidocaine detection in serum was 8.5 ± 1.4 h with a mean concentration of 51 ± 30 ng/mL. Milk T_max was detected at 1.75 ± 0.46 h with C_max of 300 ± 139 ng/mL. Milk AUC till the last time was 1869 ± 450 ng·h/mL with the mean AUC milk to AUC serum ratio of 1.439 ± 0.374. The last measurable time of lidocaine detection in milk was 32.5 ± 16.2 h with a mean concentration of 46 ± 30 ng/mL. There was no detectable lidocaine concentration in any samples following caudal epidural administration.     

A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse

Objective To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse. Study design A blinded, randomized, prospective, experimental cross‐over study. Animals Seven healthy horses, 15.7 ± 4.9 years (mean ± SD) of age, weighing 536 ± 37 kg. Methods The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg^?1 or group L: LIDO, 0.35 mg kg^?1) at intervals of at least 28 days. An 18‐gauge 80‐mm Tuohy epidural needle was placed in the first intercoccygeal space (Co1–Co2) in awake standing horses restrained in stocks. Analgesia was assessed by use of a probe maintained at a constant 62 °C by circulating hot water. The maximum stimulation time was 30 seconds. Bilateral stimulation was performed at five defined points. Before drug administration, baseline values of response time to thermal stimuli were obtained. Time to response was then measured 15 and 60 minutes after METH or LIDO administration and then hourly until the response returned to baseline at all stimulation points on two further assessments. Development of any ataxia and/or sedation was recorded. Positive pain responses were defined as purposeful avoidance movements of the head, neck, trunk, limbs and tail. Absence of attempts to kick, bite and turning of the head toward the stimulation site were used to indicate analgesia. Results Caudal epidural administration of METH and LIDO significantly increased reaction time to thermal stimulation (one‐sample t‐test; p = 0.05). Analgesia in the perineal region was present 15 minutes after both METH and LIDO administration and progressed from caudal to cranial dermatones with time. The duration of a significant increase in reaction time was 5 hours after METH injection compared to 3 hours following LIDO. All horses defaecated and urinated normally, and no excitement, sedation or ataxia were observed after METH administration. The horses were unable to defaecate normally and were moderately to severely ataxic with hindlimb weakness after LIDO. Conclusions Caudal epidural administration of methadone has considerable potential in the management of perineal, lumbo‐sacral and thoracic pain in horses. Regional differences exist in the onset, duration and intensity of the pain relief. Clinical relevance Epidural methadone administration provides analgesia with no measured side effects in these healthy adult horses.     

Epidural anesthesia and analgesia in horses.

Intercoccygeal, or caudal, epidural injection of local anesthetics is a convenient method of producing analgesia and local anesthesia of the tail and perineal structures in conscious standing horses. This technique has been further developed to provide long duration analgesia and anesthesia by placement of catheters into the epidural space of horses. More recently, opioid, alpha-2 adrenergic agonists, ketamine and other analgesic agents have been administered by caudal epidural injection, providing pain relief in both conscious, standing and anesthetized, recumbent horses. This chapter describes the development of different anesthetic and analgesic epidural techniques in horses, methods for epidural injection and catheterization, and reviews the current literature related to epidural analgesia and pain control in horses.     

In Vitro Model for Testing Novel Implants for Equine Laryngoplasty

Objective— To develop an in vitro laryngeal model to mimic airflow and pressures experienced by horses at maximal exercise with which to test laryngoplasty techniques.
Study Design— Randomized complete block.
Sample Population— Cadaveric equine larynges (n=10).
Methods— Equine larynges were collected at necropsy and a bilateral prosthetic laryngoplasty suture was placed with #5 Fiberwire^™ suture to achieve bilateral maximal arytenoid abduction. Each larynx was positioned in a flow chamber and subjected to static flow and dynamic flow cycling at 2 Hz. Tracheal pressure and flow, and pressure within the flow chamber were recorded at a sampling frequency of 500 Hz. Data obtained were compared with the published physiologic values for horses exercising at maximal exercise.
Results— Under static flow conditions, the testing system produced inspiratory tracheal pressures (mean±SEM) of −33.0±0.98 mm Hg at a flow of 54.48±1.8 L/s. Pressure in the flow chamber was −8.1±2.2 mm Hg producing a translaryngeal impedance of 0.56±0.15 mm Hg/L/s. Under dynamic conditions, cycling flow and pressure were reproduced at a frequency of 2 Hz, the peak inspiratory (mean±SEM) pharyngeal and tracheal pressures across all larynges were −8.85±2.5 and −35.54±1.6 mm Hg, respectively. Peak inspiratory flow was 51.65±2.3 L/s and impedance was 0.57±0.06 mm Hg/L/s.
Conclusions— The model produced inspiratory pressures similar to those in horses at maximal exercise when airflows experienced at exercise were used.
Clinical Relevance— This model will allow testing of multiple novel techniques and may facilitate development of improved techniques for prosthetic laryngoplasty.     

Clinical use of epidural xylazine in the horse

Xylazine was administered into the epidural space of nine horses to facilitate various perineal manipulations (ie rectovaginal laceration repair, replacement of prolapsed rectum and urethral extension). The resulting caudal analgesia was sufficient for all procedures. The duration of analgesia from a single injection of epidural xylazine (0.17 to 0.22 mg/kg bodyweight) was at least 3.5 h. No horses were ataxic during or after the treatment. This trial demonstrates that xylazine given into the epidural space of horses provides prolonged regional analgesia which is sufficient for clinical use.     

Continuous caudal epidural and subarachnoid anesthesia in mares: a comparative study

A new technique for producing continuous caudal epidural analgesia (CEA) and caudal subarachnoid analgesia (CSA) in adult horses (mares) without causing loss of pelvic limb function is described. A modified 17-gauge Huber-point directional needle was used to place a catheter with stylet into either the epidural or subarachnoid space at the lumbosacral intervertebral junction. The catheter was positioned at either the midsacral (S2-3) subarachnoid space or caudal portion of the sacral (S-3 to S-5) epidural space in 7 mares. The position of the catheter was confirmed radiographically. A 2% solution of mepivacaine HCl was used at an average dose of 0.061 +/- 0.013 mg/kg (1.3 +/- 0.3 ml) to produce CSA and 0.196 +/- 0.034 mg/kg (4.1 +/- 0.7 ml) to produce CEA. Onset of analgesia to superficial and deep muscular pinprick stimulation was faster with CSA than it was with CEA (8.2 +/- 2.4 minutes vs 21.4 +/- 3.8 minutes). Maximal caudal analgesia extended from spinal cord segments S-1 to coccyx during CSA and CEA. Periods of analgesia were shorter with CSA than with CEA (70.0 +/- 21.8 minutes vs 102.1 +/- 13.2 minutes). Perineal (S-4 to S-5) dermatome subcutaneous temperature was increased after epidural and subarachnoid injections of mepivacaine HCl solution. Heart rate, respiratory rate, systolic, diastolic, and mean arterial blood pressures, pulse pressure, rectal temperature, arterial blood gas tensions (PaCO2, PaO2), pHa, hematocrit, and total solid concentrations did not change significantly (P greater than 0.05) from base-line values after injection. The benefits and potential complications of CSA and CEA in horses are discussed.     

Pharmacokinetics and cardiopulmonary effects of guaifenesin in donkeys

Five donkeys and three horses were given guaifenesin, intravenously, by gravity administration, until recumbency was produced. The time and dose required to produce recumbency, recovery time to sternal and standing were recorded. Blood samples were collected for guaifenesin assay at 10, 20, 30, 40, 50, 60 min, and 2, 3, 4 and 6 h after guaifenesin administration. Serum was analysed for guaifenesin using HPLC and pharmacokinetic values were calculated using a computer software package (RSTRIP). In donkeys, heart and respiratory rates and blood pressures were recorded before and at 5-min intervals during recumbency. Arterial blood samples were collected before and at 5 and 15 min intervals during recumbency for analysis of pH, CO₂, and O₂. anova was used to evaluate dynamic data, while t -tests were used for kinetic values.
Respiratory rate was decreased significantly during recumbency, but no other significant changes from baseline occurred. The mean (±SD) recumbency dose of guaifenesin was 131 mg/kg (27) for donkeys and 211 mg/kg (8) for horses. Recovery time to sternal (min) was 15 (SD, 11) for donkeys and 34 (SD, 1.4) for horses. Time to standing was 32 min for donkeys and 36 min for horses. Calculation of AUC (area under the concentration–time curve) (μg.h/mL) (dose-dependent variable) was 231 (SD, 33) for donkeys and 688 (SD, 110) for horses. The clearance ( CL ) (mL/h.kg) was 546 (SD, 73) for donkeys, which was significantly different from 313 (SD, 62) for horses. Mean residence time ( MRT ) (h) was 1.2 (SD, 0.1) for donkeys and 2.6 (SD, 0.5) for horses. Volume of distribution V _d(area) (mL/kg) was 678 (SD, 92) for donkeys and 794 (SD, 25) for horses. At the rate of administration used in this study, donkeys required less guaifenesin than horses to produce recumbency, but cleared it more rapidly.     

Epidural anesthesia and postoperatory analgesia with alpha-2 adrenergic agonists and lidocaine for ovariohysterectomy in bitches

The aim of this study was to determine the viability and cardiorespiratory effects of the association of epidural alpha-2 adrenergic agonists and lidocaine for ovariohysterectomy (OH) in bitches. Forty-two bitches were spayed under epidural anesthesia with 2.5 mg/kg body weight (BW) of 1% lidocaine with adrenaline (CON) or in association with 0.25 mg/kg BW of xylazine (XYL), 10 μg/kg BW of romifidine (ROM), 30 μg/kg BW of detomidine (DET), 2 μg/kg BW of dexmedetomidine (DEX), or 5 μg/kg BW of clonidine (CLO). Heart rate (HR), respiratory rate (f_R) and arterial pressures were monitored immediately before and every 10 min after the epidural procedure. Blood gas and pH analysis were done before, and at 30 and 60 min after the epidural procedure. Animals were submitted to isoflurane anesthesia if they presented a slightest sign of discomfort during the procedure. Time of sensory epidural block and postoperative analgesia were evaluated. All animals in CON and DEX, 5 animals in ROM and CLO, 4 animals in XYL, and 3 in DET required supplementary isoflurane. All groups, except CLO, showed a decrease in HR. There was an increase in arterial pressures in all groups. Postoperative analgesia lasted the longest in XYL. None of the protocols were totally efficient to perform the complete procedure of OH; however, xylazine provided longer postoperative analgesia than the others.     

Bronchoscopy of the horse.

The endobronchial anatomy of 12 lung specimens from horses and 12 healthy, standing, sedated horses was evaluated, using a 200-cm-long, 9.5-mm-diameter videoendoscope. On the basis of these findings, the nomenclature system of Amis and McKiernan was modified for identification of airways of horses during bronchoscopy. Lobar bronchi are identified on the basis of the side of the bronchial tree on which they were found and the order in which they originated from the primary bronchus. Thus, RB1, RB2, and RB3 referred to right cranial lobar bronchus, respectively. On the left side, the designation of LB1 and LB2 refer to the left cranial lobar bronchus and the left caudal lobar bronchus, respectively. Segmental bronchi are identified by consecutive numbers in the order of origination from the lobar bronchus. The direction of the segmental bronchus was denoted by the capital letter D (dorsal), V (ventral), L (lateral), M (medial), R (rostral), and C (caudal). Subsegmental bronchi were identified in the order of origination from the segmental bronchi, using lower case letters (eg, RB2, 1V, a or RB2, 1V, aV). For subsequent branching of the subsegmental bronchi, the branches were numbered consecutively by their order of origination (eg, RB2, 1V, aV, 1D).     

Clinical evaluation of clonidine added to lidocaine solution for subarachnoid analgesia in sheep

Clonidine (CL) is a alpha2-adrenergic agonist that produces analgesia in animals and humans by a non-opiate alpha2-adrenergic action in the spinal cord dorsal horn. The objective of this prospective randomized study was to investigate the clinical effects of CL/lidocaine (LD) combination administered by the subarachnoid route in sheep. Each sheep received each of three treatments, at no shorter than weekly intervals. Treatments consisted of 0.003 mg/kg CL, 1.2 mg/kg LD and a combination of CL (0.003 mg/kg) and LD (1.2 mg/kg) (CLLD). Subarachnoid injections were given in all animals between the last lumbar and first sacral vertebra. Heart rate (HR), arterial pressures, respiratory rate, rectal temperature, analgesia, sedation, and motor blockade were determined before drug administration (basal) and 5, 10, 15 and 30 min after drug administration, and at 30-min intervals until loss of analgesia occurred. The duration of analgesia after subarachnoid CLLD administration was 187 +/- 24 min (mean +/- SD), i.e. more than twice of that obtained with CL (99 +/- 19 min) or LD (55 +/- 4.4 min) alone. In all sheep, CL, administered either alone or with LD, induced moderate sedation. After subarachnoid administration of three treatments, all sheep had ataxia and subsequent sternal recumbency. The CL treatment causes decreases in blood pressure (diastolic arterial pressure and mean arterial pressure) and HR. Data suggest that the CLLD combination could be used subarachnoidally in sheep requiring prolonged surgery.     

Efficacy of concurrent epidural administration of neostigmine and lidocaine for perineal analgesia in geldings

Objective-To evaluate perineal analgesic effects of 3 doses of neostigmine coadministered epidurally with lidocaine to geldings. Animals-6 healthy geldings. Procedures-A few days before each treatment, a catheter was inserted between the first and second coccygeal vertebrae via the caudal approach in each gelding; the catheter tip was threaded approximately 10 cm cranial into the midsacral region. Each horse received 4 epidural treatments: 2% lidocaine (0.2 mg/kg) alone and 3 doses of neostigmine (0.5, 1, or 2 μg/kg) coadministered with that same dose of lidocaine. Horses were restrained in stocks in a standing position. Heart rate, blood pressure, respiratory rate, rectal temperature, intestinal motility, analgesia, behavior, and ataxia were determined before treatment (time 0; baseline); at 5, 10, 15, 30, 45, 60, 75, and 90 minutes; and every 30 minutes thereafter until the cessation of analgesia. Results-All doses of neostigmine coadministered with lidocaine improved and extended the duration of analgesia in the perineal region of the geldings. Total duration of analgesia was not a dose-dependent effect (120, 150, and 150 minutes for 0.5, 1, and 2 μg/kg, respectively). All treatments induced mild or moderate ataxia. Cardiovascular changes were within acceptable limits. Conclusions and Clinical Relevance-Administration of neostigmine (1 μg/kg) combined with lidocaine (0.2 mg/kg) in the caudal epidural space induced analgesia for 2.5 hours with a low prevalence of adverse effects in standing conscious geldings. Epidural doses of neostigmine greater than these should be avoided because they may cause undesirable effects in geldings.     

Analgesic and motor-blocking action of epidurally administered levobupivacaine or bupivacaine in the conscious dog

Objective  To compare the analgesic and motor-blocking effects of epidurally administered levobupivacaine and bupivacaine in the conscious dog.
Study design  Prospective, randomized, cross-over study.
Animals  Six adult female Beagle dogs.
Methods  Each animal received three doses of levobupivacaine or bupivacaine (0.5, 1.0 and 1.5 mg kg⁻¹; concentrations 0.25%, 0.50%, and 0.75%, respectively) in a total volume of 0.2 mL kg⁻¹ by means of a chronically implanted epidural catheter. Onset, duration (through pinch response in the sacral, lumbar and toe areas) and degree of analgesia and motor-blocking status was determined with a scoring system and at regular intervals over 8.5 hours before (baseline) and after drug administration.
Results  Epidurally administered levobupivacaine and bupivacaine had a similar dose-dependent analgesic action with no significant differences in onset (range: 5–8 minutes), duration (bupivacaine: 42 ± 28, 135 ± 68 and 265 ± 68 minutes, and levobupivacaine: 28 ± 33, 79 ± 55 and 292 ± 133 minutes; 0.25%, 0.50%, and 0.75%, respectively) or maximum degree of analgesia. However, levobupivacaine tended to produce a shorter duration of motor block than bupivacaine and the difference in the motor to nociceptive blockade times was significant at the highest dose.
Conclusion  Epidural levobupivacaine produced an analgesic action similar to that of bupivacaine.
Clinical relevance  Epidural levobupivacaine is suitable for clinical use in dogs, mostly at the highest dose if a high degree of analgesia is required.