Vet Comp Orthop Traumatol 2010; 23(04): 225-230
DOI: 10.3415/VCOT-09-10-0107
Review Article
Schattauer GmbH

A review of the human and veterinary literature on local anaesthetics and their intraarticular use

Relevant information for lameness diagnosis in the dog
D. Van Vynckt
1   Departments of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
I. Polis
2   Department of Internal Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
F. Verschooten
2   Department of Internal Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
Van B. Ryssen
1   Departments of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
› Author Affiliations
Further Information

Publication History

Received:14 October 2009

Accepted:12 February 2010

Publication Date:
17 December 2017 (online)

Summary

Lameness in dogs is often a diagnostic challenge. In many cases it is difficult to determine the exact localisation of lameness because of the absence of palpable changes, or because of unreliable pain response due to high pain tolerance, stress or aggression of the dog. In horses and humans, intra-articular administration of local anaesthetics is commonly used for diagnostic purposes. In this review, information from human and veterinary studies on different local anaesthetic agents and their application for diagnostic intra-articular anaesthesia is given. Based on this information, a protocol for diagnostic intra-articular anaesthesia in the dog can be developed and evaluated in future studies.

 
  • References

  • 1 Schwarz T, Johnson VS, Voute L. et al. Bone scintigraphy in the investigation of occult lameness in the dog. J Small Anim Pract 2004; 45: 232-237.
  • 2 Stashak TS. Examination for lameness. In Stashak TS, Adams OR. eds). Adams Lameness in Horses. 5th ed Baltimore (MD, USA): Williams and Wilkins; 2002. pgs. 168-180.
  • 3 Equine Research King C. Lameness evaluation. In King C. editor. Lameness: Recognizing and Treating the Horse’s most common ailment. Guilford (CT, USA): Globe Pequot; 2005. pgs 19-64.
  • 4 Verschooten F. Examination of Lameness in Horses – Some Important Accents .1. Vlaams Diergeneeskundig Tijdschrift 1985; 54: 359-381.
  • 5 Neer CS, Welsh RP. The shoulder in sports. Orthop Clin North Am 1977; 8: 583-591.
  • 6 Bell JS, Hofmeister EP, Moran SL. et al. The diagnostic utility of midcarpal anesthetic injection in the evaluation of chronic wrist pain. Hand 2007; 2: 39-45.
  • 7 Lucas PE, Hurwitz SR, Kaplan PA. et al. Fluoroscopically guided injections into the foot and ankle: localization of the source of pain as a guide to treatment--prospective study. Radiology 1997; 204: 411-415.
  • 8 Crawford RW, Gie GA, Ling RS. et al. Diagnostic value of intra-articular anesthetic in primary osteoarthritis of the hip. J Bone Joint Surg Br 1998; 80: 279-281.
  • 9 Kleiner JB, Thorne RP, Curd JG. The value of bupivicaine hip injection in the differentiation of coxarthrosis from lower extremity neuropathy. J Rheumatol 1991; 18: 422-427.
  • 10 Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med 2004; 32: 1668-1674.
  • 11 Odoom JE, Allen GM, Wilson DJ. Response to local anesthetic injection as a predictor of successful hip surgery. Clin Radiol 1999; 54: 430-433.
  • 12 Smith J, Hurdle MF. Office-based ultrasound-guided intra-articular hip injection: technique for physiatric practice. Arch Phys Med Rehabil 2006; 87: 296-298.
  • 13 Spruit M, Van Goethem CJ, Kooijman MA. et al. Diagnostic infiltration of the hip joint with bupiva-caine in adult acetabular dysplasia. Acta Orthop Belg 1997; 63: 274-277.
  • 14 Faraj AA, Kumaraguru P, Kosygan K. Intra-articular bupivacaine hip injection in differentation of coxarthrosis from referred thigh pain: a 10 year study. Acta Orthop Belg 2003; 69: 518-521.
  • 15 Crawford RW, Ellis AM, Gie GA. et al. Intra-articular local anesthesia for pain after hip arthroplasty. J Bone Joint Surg 1997; 79: 796-800.
  • 16 Cook JL, Cook CR. What is the evidence?. J Am Vet Med Assoc 2009; 235: 1053-1055.
  • 17 Borer K. Local analgesic techniques in small animals. In Practice 2006; 28: 200-207.
  • 18 Stein C, Comisel K, Haimerl E. et al. Analgesic effect of intraarticular morphine after arthroscopic knee surgery. N Engl J Med 1991; 325: 1123-1126.
  • 19 Stein C, Millan MJ, Shippenberg TS. et al. Peripheral opioid receptors mediating antinociception in inflammation: evidence of involvement of mu, delta and kappa receptors. J Pharmacol Exp Ther 1989; 248: 1269-1275.
  • 20 Pascoe PJ. Opioid analgesics. Vet Clin North Am Small Anim Pract 2000; 30: 757-771.
  • 21 Keates HL, Cramond T, Smith MT. Intraarticular and periarticular opioid binding in inflamed tissue in experimental canine arthritis. Anesth Analg 1999; 89: 409-415.
  • 22 Jaureguito JW, Wilcox JF, Thisted RA. et al. The effects of morphine on human articular cartilage of the knee: an in vitro study. J Arthroscopy Rel Surg 2002; 18: 631-636.
  • 23 Sammarco JL, Conzemius MG, Perkowski SZ. et al. Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline. Vet Surg 1996; 25: 59-69.
  • 24 Rosseland LA. No evidence for analgesic effect of intra-articular morphine after knee arthroscopy: a qualitative systematic review. Reg Anesth Pain Med 2005; 30: 83-98.
  • 25 Muir WM, Hubbell JA, Bednarski RM. et al. Local anesthesia in dogs and cats. In Muir WM, Hubbell JA, Bednarski RM. et al. editors. Handbook of Veterinary Anesthesia. 4th ed Philadelphia (PA, USA): Mosby; 2007. pgs 118-139.
  • 26 Rao V, Sanjay OP, John L. et al. Intra-articular administration of morphine, bupivacaine and morphine with bupivacaine for post-operative anal-gesia following video knee arthroscopy. Indian J Anesth 2003; 47: 265-268.
  • 27 Bennett RC, Steffey EP. Use of opioids for pain and anesthetic managament in horses. Vet Clin North Am Equine Pract 2002; 18: 47-60.
  • 28 Skarda RT, Tranquilli WJ. Local Anesthetics. In Tranquilli WJ, Thurmon JC, Grimm KA. editors. Lumb & Jones’ Veterinary anesthesia and analgesia. 4th ed Ames, Iowa (USA): Blackwell Publishing; 2007. pgs 395-418.
  • 29 Dyson S. Nerve blocks and lameness diagnosis in the horse. In Pract 1984; 6: 102-107.
  • 30 Flo GL, Dyson SJ, Doherty ML. Clinical examination of the musculoskeletal system. In Radostits OM, Mayhew IG, Houston DM. editors. Veterinary clinical examination and diagnosis. Philadelphia (PA, USA): Saunders; 2000. pgs 573-660.
  • 31 Groban L, Deal DD, Vernon JC. et al. Cardiac resuscitation after incremental overdosage with lido-caine, bupivacaine, levobupivacaine, and ropiva-caine in anesthetized dogs. Anesth Analg 2001; 92: 37-43.
  • 32 Stewart J, Kellett N, Castro D. The central nervous system and cardiovascular effects of levobupiva-caine and ropivacaine in healthy volunteers. Anesth Analg 2003; 97: 412-416.
  • 33 Leone S, Di Cianni S, Casati A. et al. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed 2008; 79: 92-105.
  • 34 Santos LC, de Moraes AN, Saito ME. Effects of intraarticular ropivacaine and morphine on lipopolysaccharide-induced synovitis in horses. Vet Anesth Analg 2009; 36: 280-286.
  • 35 Hamlin RL, Bishop MA, Hadlock DJ. et al. Effects of lidocaine with or without epinephrine on ventricular rhythm. J Am Anim Hosp Assoc 1988; 24: 701-704.
  • 36 Heavner JE, Skarda RT. Local Anesthetic and Anal-gesic Techniques. In Thurmon JC, Tranquilli WJ, Benson GJ. editors. Essentials of Small Animal Anesthesia & Analgesia. Philadelphia, Pennsylvania: Illinois Lippincott Williams & Wilkins; 1999. pgs 192-224.
  • 37 Bubenik L, Hosgood G, Barker S. et al. Estimated plasma bupivacaine concentration after single dose and eight-hour continuous intra-articular infusion of bupivacaine in normal dogs. Vet Surg 2007; 36: 783-791.
  • 38 Liu PL, Feldman HS, Giasi R. et al. Comparative CNS toxicity of lidocaine, etidocaine, bupivacaine, and tet-##racaine in awake dogs following rapid intravenous administration. Anesth Analg 1983; 62: 375-379.
  • 39 Duke T. Local and regional anesthetic and analgesic techniques in the dog and cat: Part I, Pharmacology of local anesthetics and topical anesthesia. Can Vet J 2000; 41: 883-884.
  • 40 Lemke KA, Dawson SD. Local and regional anesthesia. Vet Clin North Am Small Anim Pract 2000; 30: 839-857.
  • 41 Bruelle P, Lefrant J-Y, deLaCoussaye JE. et al. Comparative electrophysiologic and hemodynamic effects of several amide local anesthetic drugs in anesthetized dogs. Anesth Analg 1996; 82: 648-656.
  • 42 Liu PL, Feldman HS, Covino BM. et al. Acute cardiovascular toxicity of intravenous amide local anesthetics in anesthetized ventilated dogs. Anesth Analg 1982; 61: 317-322.
  • 43 Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesth 1979; 51: 285-287.
  • 44 Karpie JC, Chu CR. Lidocaine exhibits dose- and time-dependent cytotoxic effects on bovine articular chondrocytes in vitro. Am J Sports Med 2007; 35: 1621-1627.
  • 45 Chu CR, Izzo NJ, Coyle CH. et al. The in vitro effects of bupivacaine on articlar chondrocytes. J Bone Joint Surg 2008; 90: 814-820.
  • 46 Nole R, Munson NM, Fulkerson JP. Bupivacaine and saline effects on articular cartilage. Arthroscopy 1985; 1: 123-127.
  • 47 Piper SL, Kim HT. Comparison of ropivacaine and bupivacaine toxicity in human articular chondrocytes. J bone Joint Surg 2008; 90: 986-991.
  • 48 White KK, Hodgson DR, Hancock D. et al. Changes in equine carpal joint synovial fluid in response to the injection of two local anesthetic agents. Cornell Vet 1989; 79: 25-38.
  • 49 Specht TE, Nixon AJ, Meyer DJ. Equine Synovia After An Intraarticular Injection of Lidocaine Or Mepivacaine. Veterinary Surgery 1988; 17: 42-49.
  • 50 Schumacher J, Schumacher J, Schramme MC. et al. Diagnostic analgesia of the equine foot. In Floyd AE, Mansmann RA. editors. Equine podiatry. St. Louis, Missouri: WB Saunders Company; 2007. pgs 128-140.
  • 51 Kramer J, Keegan KG, Wilson DA. et al. Kinematics of the hind limb in trotting horses after induced 28. lameness of the distal intertarsal and tarsometatarsal joints and intra-articular administration of anesthetic. Am J Vet Res 2000; 61: 1031-1036.
  • 52 Schmotzer WB, Timm KI. Local anesthetic techniques for diagnosis of lameness. Vet Clin North Am Equine Pract 1990; 6: 705-728.
  • 53 Schaffer TC. Joint and soft-tissue arthrocentesis. Prim Care 1993; 20: 757-770.
  • 54 Hague BA, Honnas CM, Simpson RB. et al. Evaluation of skin bacterial flora before and after aseptic preparation of clipped and nonclipped arthrocentesis sites in horses. Vet Surg 1997; 26: 121-125.
  • 55 Lozier SM, Menard M. Arthrocentesis and synovial fluid analysis. In Bojrab MJ, Ellison G, Slocum B. editors. Current Techniques in Small Animal Surgery. 4th ed Baltimore (MD, USA): Williams and Wilkins; 1998. pgs 1057-1062.
  • 56 Roberts WN, Hayes CW, Breitbach SA. et al. Dry taps and what to do about them: a pictorial essay on failed arthrocentesis of the knee. Am J Med 1996; 100: 461-464.
  • 57 Rifat SF, Moeller JL. Basics of joint injection. General techniques and tips for safe, effective use. Post-grad Med 2001; 109: 157-160.
  • 58 Wintzer HJ, Fitzek A, Frey HH. Pharmacokinetics of procaine injected into the hock joint of the horse. Equine Vet J 1981; 13: 68-69.
  • 59 Van Bree H, Van Ryssen B. Positive contrast shoulder arthrography with iopromide and diatrizoate in dogs with osteochondrosis. Vet Rad Ultra-sound 1995; 36: 203-206.
  • 60 Andreen DS, Trumble TN, Caron JP. Onset and duration of intra-articular mepivacaine in the horse. Proc Am Assoc Equine Pract 1994; 40: 151
  • 61 Dyson S. Problems associated with the interpretation of the results of regional and intra-articular anesthesia in the horse. Vet Rec 1986; 118: 419-422.
  • 62 Samoy Y, Van Ryssen B, Van Caelenberg A. et al. Single-phase bone scintigraphy in dogs with obscure lameness. The J Small Anim Pract 2008; 49: 444-450.
  • 63 Punke JP, Hulse DA, Kerwin SC. et al. Arthroscopic documentation of elbow cartilage pathology in dogs with clinical lameness without changes on standard radiographic projections. Vet Surg 2009; 38: 209-212.