How to: Perform Epidural Analgesia

Indications
Caudal epidural analgesia is an extremely useful technique in horses and can be used to facilitate obstetric manipulations, surgery on the tail, perineum and genitourinary tract and as part of intraoperative and post operative pain management protocols. The technique is contra-indicated if there is an infection at the site of needle insertion and relative contra-indications include coagulopathies, ataxia, neurological diseases and septicaemia. The temperament of the horse and personnel safety should also be considered.

Technique
Adequate restraint is essential and, if possible, the horse should be encouraged to bear weight evenly on its pelvic limbs. The first coccygeal space may be located by digital palpation (area approximately 5 cm cranial to the start of the tail hairs on the midline) during dorsoventral movement of the tail. The site should be clipped and a strict aseptic technique should be used. Local anaesthetic infiltration along the proposed needle path will reduce the horse’s response to subsequent spinal needle placement. [...]