Repeated perineural administrations of ropivacaine at the tibial nerve following a degloving injury in a horse

Abstract

The authors report a case of interventional pain management in a mare after a major degloving injury of the left hindlimb. Despite immediate surgical wound closure under general anaesthesia and multimodal systemic pain therapy during the first three weeks after surgery, the horse progressively developed signs of persistent pain. As placement of an epidural catheter was not successful, a perineural catheter was placed at the tibial nerve allowing repeated administrations of ropivacaine 0.5 per cent every six hours for nine days, leading to a reduction of pain signs. This improvement has been observed clinically as well as a reduction of pain scores recorded 30 minutes after ropivacaine injections. For the remaining 24 days of hospital stay, analgesia was provided by oral meloxicam administration and morphine administered through a newly placed epidural catheter. The horse was discharged from the hospital with minor signs of pain 57 days after injury.