Equine veterinary journal · 2024
Local anaesthetic delivery through indwelling retrobulbar catheters for ocular pain control in horses.
СтатьяRandomized Controlled Trial, VeterinaryНазвание и аннотация: Перевод в очереди
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Moody Leah M, Hicks Sherri L, Foote Braidee C, Hendrix Diane V, Ward Daniel A
Аннотация
BACKGROUND: Equine corneal disease is common and painful. Current pain mitigation strategies are often suboptimal, especially early in the disease.
OBJECTIVES: To evaluate the effects of local anaesthetic delivery via indwelling retrobulbar catheter on corneal sensitivity, pupil size, pupillary light responses (PLRs), and ocular motility in normal horses.
STUDY DESIGN: Randomised, controlled crossover experiment.
METHODS: One eye was randomly selected from seven horses. A 20-gauge catheter was placed in the retrobulbar space and injected with 10 mL of 0.5% bupivacaine or 0.9% saline. Cochet-Bonnet esthesiometry (CBE), pupil photogrammetry, PLRs, and oculocephalic reflexes were evaluated before injection (t = 0) and t = 0.25, 1, 3, 6, 9 and 12 h after injection. Following a 7-14 day washout period, this procedure was repeated using the alternative injection solution. Corneal touch thresholds (CTTs) derived from CBE and pupillary areas (PA; as measured from photographs) were compared across time for each group. PLRs and oculocephalic reflexes were compared between groups at each evaluation time point.
RESULTS: Saline did not affect CBE, PA, PLRs or oculocephalic reflexes at any time point. Bupivacaine reduced CTT compared with saline for 6 h, with maximum reduction at t = 1 h (bupivacaine: 0.08 ± 0.20 cm; saline: 4.21 ± 0.39 cm; p < 0.001). Bupivacaine increased PA compared with saline for 3 h, with maximum increase at t = 3 h (bupivacaine: 349.75 ± 84.80 mm2; saline: 194.65 ± 27.03 mm2; p = 0.04). Bupivacaine injection reduced PLRs for 9 h and oculocephalic reflexes for 3 h; saline had no effect. Mild adverse effects included chemosis, blepharoedema, and transiently reduced palpebral reflex.
MAIN LIMITATIONS: Reduction in CTT may not directly translate to pain control in clinical horses with corneal disease. Adverse effects of repeated injections were not evaluated.
CONCLUSIONS: Injection of bupivacaine via an indwelling retrobulbar catheter in horses reduces corneal sensitivity and may be useful in reducing pain in horses with corneal disease.
OBJECTIVES: To evaluate the effects of local anaesthetic delivery via indwelling retrobulbar catheter on corneal sensitivity, pupil size, pupillary light responses (PLRs), and ocular motility in normal horses.
STUDY DESIGN: Randomised, controlled crossover experiment.
METHODS: One eye was randomly selected from seven horses. A 20-gauge catheter was placed in the retrobulbar space and injected with 10 mL of 0.5% bupivacaine or 0.9% saline. Cochet-Bonnet esthesiometry (CBE), pupil photogrammetry, PLRs, and oculocephalic reflexes were evaluated before injection (t = 0) and t = 0.25, 1, 3, 6, 9 and 12 h after injection. Following a 7-14 day washout period, this procedure was repeated using the alternative injection solution. Corneal touch thresholds (CTTs) derived from CBE and pupillary areas (PA; as measured from photographs) were compared across time for each group. PLRs and oculocephalic reflexes were compared between groups at each evaluation time point.
RESULTS: Saline did not affect CBE, PA, PLRs or oculocephalic reflexes at any time point. Bupivacaine reduced CTT compared with saline for 6 h, with maximum reduction at t = 1 h (bupivacaine: 0.08 ± 0.20 cm; saline: 4.21 ± 0.39 cm; p < 0.001). Bupivacaine increased PA compared with saline for 3 h, with maximum increase at t = 3 h (bupivacaine: 349.75 ± 84.80 mm2; saline: 194.65 ± 27.03 mm2; p = 0.04). Bupivacaine injection reduced PLRs for 9 h and oculocephalic reflexes for 3 h; saline had no effect. Mild adverse effects included chemosis, blepharoedema, and transiently reduced palpebral reflex.
MAIN LIMITATIONS: Reduction in CTT may not directly translate to pain control in clinical horses with corneal disease. Adverse effects of repeated injections were not evaluated.
CONCLUSIONS: Injection of bupivacaine via an indwelling retrobulbar catheter in horses reduces corneal sensitivity and may be useful in reducing pain in horses with corneal disease.