Opioid‐free anaesthesia protocol for standing spinal surgery in a horse

Abstract

Opioid‐free anaesthesia is a growing field in human and veterinary medicine. Several adverse effects have been reported related to the administration of opioids in horses, including the propensity to produce excitement, ataxia and gastrointestinal stasis. However, opioids have traditionally been the mainstay of pain relief in both the human and veterinary field. The feasibility of an opioid‐free anaesthesia protocol in a horse that underwent multiple subtotal spinous process ostectomies is reported here. Instead of traditional opioid therapy, a detomidine continuous‐rate infusion and a bilateral ultrasound‐guided erector spinae block was performed to provide analgesia. The authors concluded that opioid‐free surgical anaesthesia protocols may be feasible in horses undergoing multiple subtotal spinous process ostectomies. Gaining experience with these protocols may be advantageous when the use of opioids is to be avoided.

Objective methods of nerve localisation to facilitate performing locoregional anaesthetic techniques for horses undergoing surgical procedures

“…This locoregional technique may be useful for desensitising the structures supplied by the dorsal rami of the thoracic and lumbar spinal nerves, specifically to identify and treat conditions affecting the spinous processes of the vertebrae. Recently, three case reports have been published demonstrating the use of ultrasound‐guided ESP (UG‐ESP) block in horses undergoing ostectomy and interspinous ligament desmotomy (Chiavaccini et al., 2022; Perez et al., 2023; Rodriguez et al., 2022). Perez et al.…”

“…(2023) performed the procedure bilaterally under standing sedation, targeting the transverse process of T13 and T18. Utilising 20 mL 2% lidocaine hydrochloride at each of the four sites, the authors reported an effective block for at least 140 min, after which a top‐up dosage of 5 μg/kg of detomidine and a splash block with 40 mL of 2% lidocaine in the surgical area were required due to an increase of 27% in the pulse rate and slight movement of the horse during surgical manipulation (Perez et al., 2023). Rodriguez et al.…”

“…At least one dorsal rami of the thoracic nerves were stained, whereas the ventral rami (intercostal nerves) were stained in only three injections.This locoregional technique may be useful for desensitising the structures supplied by the dorsal rami of the thoracic and lumbar spinal nerves, specifically to identify and treat conditions affecting the spinous processes of the vertebrae. Recently, three case reports have been published demonstrating the use of ultrasound-guided ESP (UG-ESP) block in horses undergoing ostectomy and interspinous ligament desmotomy(Chiavaccini et al, 2022;Perez et al, 2023;Rodriguez et al, 2022) Perez et al (2023). performed the procedure bilaterally under standing sedation, targeting the transverse process of T13 and T18.…”