ISSN 2398-2977      

Anesthesia: analgesia - overview

pequis

Introduction

Why is pain control necessary in the horse?

  • Uncontrolled pain causes suffering and stress, so it is unethical not to treat it.
  • Uncontrolled pain will result in chronic pain.
  • Pain activates a stress response.
  • The stress response initially is physiological and aims to restore homeostasis until the injury has healed.
  • A prolonged stress response has a negative impact on homeostasis causing tachycardia, vasoconstriction and hypertension and increase myocardial oxygen consumption; decreasing gastric emptying time, reducing gut motility and promoting postoperative ileus and colic in horses; causing immunodepression increases the risk of infection and delays healing processes Wound: healing - factors.
  • A painful horse might also become anorexic and lose weight.
  • Its metabolism will shift towards catabolism.
  • Pain might worsen the recovery from general anesthesia and increase likelihood of post-operative complications.
  • Pain will modify the horse behavior (ie aggression, decreased responsiveness) and it could be the reason for self-mutilation behaviors Behavior: self-mutilation resulting in further wounds and more pain.

Pain is not a good or ethical technique for restricting movement.

Definitions

  • Pain perception = an unpleasant sensory and emotional experience associated with actual or potential tissue damage or resembling that caused by actual or potential tissue injury.
  • Note: the inability to communicate in no way negates the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment.
  • Inflammatory visceral pain = thoracic and abdominal visceral pain; poorly localized, undulating in severity and may be referred to cutaneous sites.
  • Inflammatory somatic = skin, joint, muscle or periosteal pain; localized, throbbing, acute; may be superficial or deep.
  • Neuropathic pain = damage to peripheral or spinal nervous tissue; burning stabbing sensation; may be unresponsive to treatment.
  • Idiopathic pain = no recognizable organic cause; may be exaggerated and exacerbated by stress (fear or excitement).
Print off the Owner factsheet All about anesthesia to give to your clients.

Signs of pain in the horse

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Methods of providing analgesia

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Other methods of providing analgesia

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bowen I M, Redpath A et al (2020) BEVA primary care clinical guidelines: analgesia. Equine Vet J 52 (1), 13-27 WileyOnline.
  • Tessier C, Pitaud J P, Thorin C & Touzot-Jourde G (2019) Systemic morphine administration causes gastric distention and hyperphagia in healthy horses. Equine Vet J 51 (5), 653-657 PubMed.
  • Knych H K (2017) Nonsteroidal anti-inflammatory drug use in horses. Vet Clin North Am Equine Pract 33 (1), 1-15 PubMed.
  • Gozalo-Marcilla M, Gasthuys F & Schauvliege S  (2015) Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 2: opioids and alpha-2 adrenoceptor agonists. Vet Anaesth Analg 42 (1), 1-16 PubMed.
  • Gozalo-Marcilla M, Gasthuys F & Schauvliege S  (2015) Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 2: opioids and alpha-2 adrenoceptor agonists. Vet Anaesth Analg 42 (1), 1-16 PubMed.
  • van Loon J P A M (2014) Multimodal strategies for equine analgesia, one step beyond. Equine Vet Educ 26 (2), 72-74 WileyOnline.
  • Figueiredo J P, Muir W W & Sams R (2012) Cardiorespiratory, gastrointestinal, and analgesic effects of morphine sulfate in conscious healthy horses. Am J Vet Res 73 (6), 799-808 PubMed.
  • Michou J & Leece E (2012) Sedation and analgesia in the standing horse 2. Local anaesthesia and analgesia techniques. In Pract 34 (10), 578-587 VetMedResource.
  • Michou J & Leece E (2012) Sedation and analgesia in the standing horse 1. Drugs used for sedation and systemic analgesia. In Pract 34 (9), 524-531 VetMedResource.
  • Hubbell J A E, Saville W J A & Bednarski R M (2010) The use of sedatives, analgesic and anaesthetic drugs in the horse: An electronic survey of members of the Americal Association of Equine Practitioners (AAEP). Equine Vet J 42 (6), 487-493 PubMed.
  • Clark L, Clutton R E, Blissitt K J & Chase-Topping M E (2008) The effects of morphine on the recovery of horses from halothane anaesthesia. Vet Anaesth Analg 35 (1), 22-29 PubMed.
  • Coomer R (2007) Colic Part 1: History, pain and analgesics. UK Vet 12 (2), 5-10 VetMedResource.
  • Roethlisberger Holm K et al (2006) Effect of local analgesia on movement of the equine back. Equine Vet J 38 (1), 65-69 PubMed.
  • Love E J, Lane J G & Murison P J (2006) Morphine administration in horses anaesthetized for upper respiratory tract surgery. Vet Anaesth Analg 33 (3), 179-188 PubMed.
  • Boscan P, Van Hoogmoed L M, Farver T B & Snyder J R (2006) Evaluation of the effects of the opioid agonist morphine on gastrointestinal tract function in horses. Am J Vet Res 67 (6), 992-997 PubMed.
  • Clark L, Clutton R E, Blissitt K J & Chase-Topping M E (2005) Effects of peri-operative morphine administration during halothane anaesthesia in horses. Vet Anaesth Analg 32 (1), 10-15 PubMed.
  • Cohen N D, Lester G D, Sanchez L C, Merritt A M, Roussel A J Jr (2004) Evaluation of risk factors associated with development of postoperative ileus in horses. JAVMA 225 (7), 1070-1078 PubMed.
  • Sellon D C, Roberts M C, Blikslager A T, Ulibarri C & Papich M G (2004) Effects of continuous-rate infusion of butorphanol on physiologic and outcome variables in horses after celiotomy. J Vet Intern Med 18 (4), 555-563 PubMed.
  • Hubbell J A E & Muir W W (2004) Use of the alpha-2 agonists xylazine and detomidine in the perianaesthetic period in the horse. Equine Vet Educ 16 (6), 326-332 VetMedResource.
  • Mircica E, Clutton R E, Kyles K W & Blissitt K J (2003) Problems associated with perioperative morphine in horses: a retrospective case analysis. Vet Anaesth Analg 30 (3), 147–155 PubMed.
  • Clark J O et al (1999) Analgesia. Vet Clin North Am Equine Pract 15 (3), 705-723 PubMed.
  • Muir W W (1998) Anesthesia and pain management in horses. Equine Vet Educ 10 (6), 335-340 VetMedResource.
  • England G C et al (1996) Alpha 2 adrenoceptor agonists in the horse - a review. Br Vet J 152 (6), 641-657 PubMed.
  • Owens H G et al (1996) Evaluation of detomidine-induced analgesia in horses with chronic hoof pain. J Pharmacol Exp Ther 278 (1), 179-184 PubMed.
  • Owens J G et al (1995) Effects of ketoprofen and phenylbutazone on chronic hoof pain and lameness in the horse. Equine Vet J 27 (4), 296-300 PubMed.
  • Miller S M et al (1995) Quantitative electroencephalographic evaluation to determine the quality of analgesia during anesthesia of horses for arthroscopic surgery. Am J Vet Res 56 (3), 374-379 PubMed.
  • Hubbell J A et al (1994) Emergency analgesia and chemical restraint in the horse. Vet Clin North Am Equine Pract 10 (3), 503-516 PubMed.
  • Roger T, Bardon T & Ruckebusch Y (1994) Comparative effects of mu and kappa opiate agonists on the cecocolic motility in the pony. Can J Vet Res 58 (3), 163-166 PubMed.
  • Johnson C B et al (1993) Post-operative analgesia using phenylbutazone, flunixin or carprofen in horses. Vet Rec 133 (14), 336-338 PubMed.
  • Geiser D R (1990) Chemical restraint and analgesia in the horse. Vet Clin North Am Equine Pract 6 (3), 495-512 PubMed.

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