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How to Place an Epidural Catheter Easily and Maximize Its Clinical Effects
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1. Introduction
Epidural anesthesia is a beneficial mode of pain management in the equine practice.1,2 It is an easy technique that can have profound effects on acute and chronic pain.1–3 Using the epidural space allows for direct analgesic effects in the dorsal horn of the spinal cord, which minimizes systemic effects. A smaller dose of a drug can be used in epidural anesthesia, and it will oftentimes have a longer duration of action than when used systemically.4 Epidural anesthesia and analgesia have long been used primarily for orthopedic and soft tissue conditions affecting the hindlimbs and perineal region.1–5 However, there are reports of infused volumes that provide similar effects for the forelimbs, abdomen, or thoracic structures.2 Epidural catheters can be easily maintained in hospital settings and result in few complications with long-term use.2
2. Materials and Methods
Locating the site for epidural catheter placement can easily be determined by palpating the junction between the first and second coccygeal vertebrae. The space can be palpated while the tail is moved in an up-and-down motion. An area ~15 x 15 cm is clipped and sterilely prepared (Fig. 1). Lidocaine (1.0–1.5 ml) should be injected into the skin and dermis at the site (Fig. 2). After sterile preparation of the region, the horse should be sedated as needed to ensure that movement is minimized. Sterile gloves are used when placing the catheter. [...]
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