Regional analgesias in surgery: the anaesthesiologist's view

Notwithstanding the economical, clinical and welfare benefits of analgesia are widely accepted in horses; in the author’s anecdotal opinion, horses that are in pain are more likely to be difficult to maintain in a smooth plane of anaesthesia and more likely to attempt to stand sooner and be ataxic/ have difficulty in standing in recovery, especially if the pain is orthopaedic in origin. It thus makes sense that we should endeavour to provide multimodal analgesia to horses undergoing invasive surgical procedures, and whilst no drug is without side effects and no intervention riskfree, resistance to the routine use of regional analgesia by some clinicians may be adversely affecting outcomes for their patients. The problem in any debate on the benefits of analgesia on equine surgical outcomes is the lack of robust evidence (e.g. double-blinded multicentre randomised clinical trials), and the evidence that does exist on both sides of the debate is often patchy and inconsistent.

The positive aspects of regional analgesia in horses are that they can improve convalescence and shorten duration of stay in clinics, partly because such techniques have greatly facilitated the increased utilisation of standing surgical techniques to avoid the risk of general anaesthesia. [...]