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Equine Practice
An approach to hindlimb lameness 3. Local analgesic techniques
  1. Sue Dyson

    Sue Dyson graduated from Cambridge in 1980. She completed an internship in large animal medicine and surgery at the University of Pennsylvania and then spent a year in private equine practice in Pennsylvania before returning to the UK to take up a clinical orthopaedic position in the Equine Centre of the Animal Health Trust, Newmarket. She gained a PhD for a thesis on equine lameness diagnosis and was awarded fellowship of the RCVS for a thesis on shoulder lameness in the horse. She holds the RCVS diploma in equine orthopaedics. Her special interests include equine lameness diagnosis and diagnostic imaging.

Abstract

PERINEURAL local analgesia, ring blocks, intrasynovial analgesia and intrathecal analgesia are integral parts of many lameness investigations, either to identify or confirm the site(s) of pain. Before performing any form of local anaesthesia, it is important to establish the consistency of lameness and to be aware of the limitations of the techniques. If lameness is only slight and tends to improve spontaneously with exercise, interpretation of a nerve block is difficult. Very severe lameness, although consistent, may be improved only marginally by local analgesia. The order in which local analgesic techniques should be performed is determined by the presenting clinical signs and the skill of the investigator. An experienced clinician may be reasonably confident that pain arises from the tarsometatarsal joint, and therefore proceed directly to intra-articular analgesia of the joint, whereas it may well behove an inexperienced practitioner to start with desensitisation of the foot region and proceed step-wise proximally.

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