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1.
Donald  R.  Trout  DVM  PhD  William  J.  Hornof  DVM  MS  Charles C.  Liskey  DVM  Paul  E.  Fisher  BS 《Veterinary radiology & ultrasound》1991,32(3):140-144
Soft tissue phase scintigrams were acquired from 7 normal horses before and over a 17-day period after palmar digital, abaxial sesamoid, low palmar and high palmar nerve blocks. Bone phase scintigrams were acquired from 4 additional horses prior to performing similar regional anesthesia and over a 14-day period postanesthesia. Images were evaluated subjectively and quantitatively for increased activity in nerve block regions. On soft tissue phase scintigrams, palmar digital and abaxial sesamoid blocks resulted in increases in activity which were relatively mild, of short duration, and subjectively had little or no effect on image interpretation. Low palmar and high palmar blocks resulted in obvious focal accumulation of activity during the soft tissue phase. Such increases in activity were usually greatest at 1 day postanesthesia and persisted up to 17 days postanesthesia. On bone phase scintigrams, abnormal accumulation of activity was not evident.  相似文献   

2.
The nerve distribution to the digit of the horse was studied with the compound microscope in serial transverse sections of fetal limbs and plotted on life-size outlines of the horse's foot. It was learned that there is much variation in the topography of the branches of the principal nerves. There is no mirror-image nerve distribution on the 2 sides of the foot. The dorsal branch of the ulnar nerve does not extend below the fetlock. The communication between the palmar metacarpal nerves and branches of the dorsal branch of the digital nerves is only a crossing of nerves without exchange of fibers. The palmar metacarpal nerves usually do not innervate structures distal to the pastern joint. The innervation of the deep structures of the equine foot was tabulated.  相似文献   

3.
Objective To develop a technique for placing continuous peripheral nerve block (CPNB) catheters adjacent to palmar nerves in horses and to evaluate the effect of low‐volume local anesthetic (LA) infusion on nociception in the distal equine thoracic limb. Study design In vitro and in vivo laboratory investigation. Study material and animals Forty‐two thoracic limbs from 22 equine cadavers and five horses. Methods Thoracic limb specimens were dissected to find landmarks for catheter insertion adjacent to medial and lateral palmar nerves. Based on the anatomy of the proximal metacarpus, a technique for placing palmar CPNB catheters was developed and the potential for catheter dislodgement studied in vitro by fluoroscopic visualization during passive carpal flexion and dye injection following simulated limb motion. The feasibility of CPNB catheter instrumentation in standing, sedated horses was tested in five animals, with ultrasound control. Electrical and mechanical stimulation thresholds and response latencies for hoof withdrawal responses (HWR) were determined following saline or LA infusion. Results Medial and lateral CPNB catheters were inserted percutaneously 2 and 4–5 cm, respectively, distal to the accessory carpal bone and advanced for ～7 and 10 cm, respectively, to place the tip just proximal to the communicating branch of the nerves. Catheters were placed correctly in 88% and 85% of cadaver limbs. In the standing horses, LA infusion not only increased HWR thresholds and latencies to noxious mechanical or electrical stimulation but also caused vasodilation and limb swelling over time. Conclusion The technique, developed in vitro, for placing and maintaining palmar CPNB catheters in the equine thoracic limb was successfully applied in vivo. Catheters were well tolerated but LA infusion may cause limb swelling, suggesting a need for further exploration of drug and infusion regimens. Clinical relevance Continuous perineural LA infusion along palmar nerves may develop into an effective analgesic technique in horses suffering from lower limb pain.  相似文献   

4.
Normal nerve conduction velocity values in 10 ponies were determined for sensory nerve fibers in the median and ulnar nerves. A percutaneous signal-averaging technique was developed and used. Medial and lateral palmar digital nerves on the abaxial surface of the proximal sesamoid bones were used as the sites for percutaneous stimulation, whereas recording sites included the medial and lateral palmar nerves just distal to the carpus and the median and ulnar nerves in the middle of the radius. Sensory nerve conduction velocities can be evaluated simply and clinically in the limbs of horses, using percutaneous signal-averaging techniques.  相似文献   

5.
Diagnostic analgesia of the distal interphalangeal (DIP) joint is theoretically helpful to localize the source of pain in the foot to the joint and/or navicular bursa. However, it has been suggested that potential diffusion of local anesthetic agent to nearby distal limb nerves may anesthetize other areas of the foot. The objective of this study was to compare the results of palmar digital (PD) and abaxial sesamoid (AS) nerve blocks to intra-articular anesthesia of the DIP joint in horses with distal forelimb lameness. Palmar digital nerve block (group 1) or PD and AS nerve blocks (group 2) were used to abolish digital pain in 22 horses. The following day lameness was again evaluated in all horses before and 2, 5, and 10 minutes after DIP joint anesthesia. All lameness evaluations were performed objectively with a body-mounted inertial sensor system (Lameness locator; Equinosis LLC, Columbia, MO). In group 1 horses, overall improvement in group lameness was the same after DIP joint block, but only six showed positive response after DIP joint analgesia, five after 2 minutes, and one after 5 minutes. In group 2 horses, overall improvement in lameness was less after DIP joint block, with seven showing a positive response after DIP joint analgesia, one after 2 minutes, four after 5 minutes, and two after 10 minutes. Intra-articular analgesia of the DIP joint and perineural analgesia of the digit result in overlapping but unequal areas of analgesia. In addition, a time-dependent response was observed after DIP joint block with full effect requiring 5–10 minutes.  相似文献   

6.
Reasons for performing study: The flexion test is used routinely as part of lameness and prepurchase examinations. However, little is known about the mechanisms that cause a positive response to a flexion test. Objective: To determine which anatomical regions play a role in a positive outcome of a flexion test of the distal aspect of a forelimb in a nonlame horse. Methods: Eight clinically sound Dutch Warmblood horses were subjected to a standardised flexion test (force 250 N, time 60 s) inducing a consistent lameness. To discriminate between different areas of the distal aspect of a forelimb, effects of various nerve blocks on the outcome of the flexion test were investigated. Low palmar digital, palmar at the abaxial aspects of the base of the proximal sesamoids, high palmar, ulnar and low 4‐point nerve blocks were performed. Flexion test induced lameness was scored before and after each nerve block in separate sessions. Results: The low palmar digital nerve blocks and nerve blocks of the palmar nerves at the abaxial aspect of the base of the proximal sesamoid bones had no significant effect on the flexion test induced lameness score. The ulnar, high palmar and, most dramatically, the low 4‐point nerve blocks all caused a significant (P<0.05) reduction in the flexion test induced lameness score. Conclusions: Anatomical structures (soft tissue nor synovial structures) located distal to the metacarpophalangeal joint appear to contribute only minimally to the outcome of a positive flexion test of the distal aspect of a forelimb in a clinically nonlame horse. The structures in the region of, and including, the metacarpophalangeal joint appear to contribute most to a positive flexion test of the distal aspect of a forelimb in a nonlame horse. Potential relevance: The flexion test of the distal aspect of a forelimb may be sensitive for investigating the metacarpophalangeal joint region in horses free from lameness, but may be less relevant for structures distal to this region.  相似文献   

7.
Analgesia usually occurs within 5 min after administration of local anaesthetic solution into joints or around nerves in the distal portion of the limb. Gait should be assessed within 10 min after diagnostic regional analgesia of the distal portion of the limb because rapid diffusion of anaesthetic solution can result in anaesthesia of other nerve branches, thus confusing results of the examination. A palmar digital nerve block (PDNB) anaesthetises most of the foot, including the distal interphalangeal (DIP) joint (coffin joint), rather than just the palmar half of the foot, as was once commonly believed. To avoid partially anaesthetising the proximal interphalangeal joint (pastern joint), the palmar digital nerves should be anaesthetised near or distal to the proximal margin of the collateral cartilages. Clinicians should be aware that an abaxial sesamoid nerve block (ASNB) may ameliorate or abolish pain within the metacarpo/metatarso‐phalangeal joint (fetlock joint). Mepivacaine administered into the DIP joint desensitises the DIP joint and probably the palmar digital nerves to also cause anaesthesia of the navicular bursa, the navicular bone, the toe region of the sole, the digital portion of the deep digital flexor tendon (DDFT) and the distal portions of the collateral ligaments of the DIP joint. When a large volume of mepivacaine HCl (e.g. 10 ml) is administered, the heel region of the sole may also be desensitised. Only a small percentage of horses with disease of the collateral ligament(s) of the DIP joint show a significant improvement in lameness after intra‐articular analgesia of the DIP joint, and no horse is likely to improve after intrabursal analgesia of the navicular bursa. A PDNB, however, improves lameness substantially in most horses that are lame because of disease of the collateral ligament(s) of the DIP joint, and all affected horses are likely to become sound after an abaxial sesamoid nerve block. The degree of improvement in lameness associated with injury to one or both collateral ligaments of the DIP joint after PDNB is determined by the extent of the injury and the level at which the palmar digital nerves are anaesthetised. The further proximal the level of the injury within the collateral ligament, the less likely that lameness is ameliorated by analgesia of the DIP joint or a PDNB. Verschooten's technique appears to be the most accurate technique for centesis of the navicular bursa. Even though analgesia of the DIP joint results in analgesia of the navicular bursa, analgesia of the navicular bursa does not result in analgesia of the DIP joint. Pain arising from the DIP joint can probably be excluded as a cause of lameness when lameness is attenuated by analgesia of the navicular bursa. Analgesia of the digital flexor tendon sheath (DFTS) is likely to desensitise only structures that are contained within or border on the sheath itself (i.e. the superficial and deep digital flexor tendons, the straight and oblique distal sesamoidean ligaments, the annular ligaments of the fetlock and pastern, and the portion of the DDFT that lies within the foot). Because lameness caused by disease of the DDFT within the foot may fail to improve appreciably after analgesia of the palmar digital nerves, the DIP joint, or the navicular bursa, a portion of the DDFT within the foot and distal to the DFTS probably receives its sensory supply from more proximal deep branches of the medial and lateral palmar digital nerves that enter the DFTS. Performing intrathecal analgesia of the DFTS on horses with lameness that is unchanged after anaesthesia of the palmar digital nerves but resolves after an ASNB, may be useful in localising lameness to that portion of the DDFT that lies within the foot. Resolution of lameness after intrathecal analgesia of the DFTS justifies suspicion of a lesion within the digital portion of the DDFT or within structures contained within the DFTS. The belief that concurrent or sequential intra‐articular administration of medication substantially increases the risk of joint infection or that inflammation caused by the local anaesthetic solution may dampen the therapeutic response to intra‐articular medication appears to be unfounded.  相似文献   

8.
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9.
Reasons for performing study: There is limited information on potential diffusion of local anaesthetic solution after various diagnostic analgesic techniques of the proximal metacarpal region. Objective: To document potential distribution of local anaesthetic solution following 4 techniques used for diagnostic analgesia of the proximal metacarpal region. Methods: Radiodense contrast medium was injected around the lateral palmar or medial and lateral palmar metacarpal nerves in 8 mature horses, using 4 different techniques. Radiographs were obtained 0, 10 and 20 min after injection and were analysed subjectively. A mixture of radiodense contrast medium and methylene blue was injected into 4 cadaver limbs; the location of the contrast medium and dye was determined by radiography and dissection. Results: Following perineural injection of the palmar metacarpal nerves, most of the contrast medium was distributed in an elongated pattern axial to the second and fourth metacarpal bones. The carpometacarpal joint was inadvertently penetrated in 4/8 limbs after injections of the palmar metacarpal nerves from medial and lateral approaches, and in 1/8 limbs when both injections were performed from the lateral approach. Following perineural injection of the lateral palmar nerve using a lateral approach, the contrast medium was diffusely distributed in all but one limb, in which the carpal sheath was inadvertently penetrated. In 5/8 limbs, following perineural injection of the lateral palmar nerve using a medial approach, the contrast medium diffused proximally to the distal third of the antebrachium. Conclusions and potential relevance: Inadvertent penetration of the carpometacarpal joint is common after perineural injection of the palmar metacarpal nerves, but less so if both palmar metacarpal nerves are injected using a lateral approach. Following injection of the lateral palmar nerve using a medial approach, the entire palmar aspect of the carpus may be desensitised.  相似文献   

10.
Limited information exists on distribution of local anaesthetic solution following palmar digital nerve blocks. The aim of this study was to demonstrate potential distribution of local anaesthetic solution following perineural injection of the palmar digital nerves using 2 different volumes of contrast medium and 2 different injections sites. Twelve mature horses were used. Perineural injection of the palmar digital nerves were performed at the level of or 2 cm proximal to the proximal aspect of the ipsilateral ungular cartilage, using 1.5 or 2.5 ml radiopaque contrast medium. In total, 96 injections were performed. Four standard radiographic views of the pastern were obtained immediately after injections and 10 and 20 min later. Images were analysed subjectively and objectively. After distal injections, the contrast medium was more localised around the injection site; after proximal injections the contrast patch had greater proximal–distal length. The greatest proximal diffusion was to 31.7% of the length of the proximal phalanx (from the level of the proximal interphalangeal joint) after distal injections and to 70% after proximal injections. The larger volume resulted in significantly greater proximal diffusion than the smaller volume at the distal, but not at the proximal injection site (P<0.01). There was significant proximal diffusion with time after proximal and distal injections (P<0.01). In most limbs, numerous radiopaque lines of various thickness extended proximally from the contrast patches; subjectively, their number and thickness were greater at the distal injection site. In conclusion, palmar digital nerve blocks at the level of the ungular cartilage using ≤2.5 ml local anaesthetic solution may improve proximal interphalangeal joint and pastern region pain. If using a more proximal site, distal fetlock region pain may be improved. Due to diffusion into lymphatic vessels, too small a volume at the distal injection site may not provide sufficient analgesia.  相似文献   

11.
Desmitis of the proximal aspect of the suspensory ligament, or interosseus medius muscle, of the pelvic or thoracic limb is a commonly diagnosed cause of lameness of performance horses. Despite medical treatments available for horses with proximal suspensory desmitis (PSD), most horses treated medically for PSD of a pelvic limb remain persistently lame; this persistent lameness may be the result of a neuropathy caused by compression of nerves by an enlarged suspensory ligament. Few horses with PSD of a thoracic limb remain persistently lame. Based on the results of reports citing successful treatment of horses chronically lame because of PSD of a pelvic or thoracic limb, by excising a portion of the deep branch of the lateral plantar or palmar nerve (DBLPlN/DBLPaN), we theorized that persistent lameness of horses caused by PSD of a thoracic limb may also be due to compression of nerves that supply the ligament. The aim of this study was to determine if histological signs of compression neuropathy of the DBLPaN are present in horses with PSD in a thoracic limb. To test this hypothesis, we induced PSD by instilling collagenase into the ligament and then examined the DBLPaN after harvesting this nerve 2 months later. We found that the DBLPaNs of all treated limbs showed histologic changes suggestive of nerve compression. We conclude that studies examining the DBLPaN of horses with naturally occurring PSD for histological evidence of neuropathy are warranted.  相似文献   

12.
Clinical features of proximal suspensory desmopathy (PSD) and concurrent injury of the proximal aspect of the accessory ligament of the deep digital flexor tendon (ALDDFT) have not been documented. The objectives were to describe clinical signs and diagnosis. This was a retrospective study. Patient details, lame limb(s), response to diagnostic analgesia, and radiographic and ultrasonographic findings were recorded. PSD and injury of the proximal aspect of the ALDDFT were identified in 19 horses, 14 with forelimb lameness (unilateral 5, bilateral 9) and 5 with hindlimb lameness (unilateral 2, bilateral 3). Localising clinical signs were seen in 7/31 lame limbs (subtle thickening in the region of the ALDDFT [n = 3], pain on palpation of the body of the suspensory ligament (SL) [n = 6], heat in the proximal metacarpal or metatarsal region [n = 2]). Forelimb lameness was abolished by perineural analgesia of the palmar metacarpal (subcarpal) nerves in 17/23 limbs. In the remaining limbs intra‐articular analgesia of the middle carpal joint (n = 2) or an ulnar nerve block (n = 4) were required to eliminate the lameness. Hindlimb lameness was abolished by perineural analgesia of the deep branch of the lateral plantar nerve (n = 2) or local infiltration of the proximal plantar aspect of the metatarsus (n = 3); a tibial nerve block resolved lameness in the remaining 3 limbs. Lesions of the SL and of the ALDDFT were characterised ultrasonographically by enlargement, heterogeneous echogenicity and loss of long linear echoes in longitudinal images. In 3 horses adhesions between the ALDDFT and the SL were identified post mortem. Close apposition of these structures seen ultrasonographically may indicate adhesion formation. It was concluded that the clinical features of PSD and concurrent injury of the ALDDFT are similar to those for PSD alone, highlighting the need for comprehensive and systematic ultrasonographic assessment.  相似文献   

13.
Our aims were to evaluate the pattern of radiopharmaceutical uptake in horses with lameness related to the metacarpophalangeal and/or metatarsophalangeal joint and compare the results with similar information from sound horses. It was hypothesized that there would be a difference in radiopharmaceutical uptake between the lame and contralateral limb in unilaterally lame horses and that there would be a difference between lame and sound horses. Nuclear scintigraphic images of 43 horses with forelimb lameness and 30 horses with hindlimb lameness were evaluated. In all horses lameness was improved by intraarticular analgesia of the joint, or by perineural analgesia of the palmar/plantar (at the junction of the proximal 3/4 and the distal 1/4 of the metacarpal/metatarsal regions) and palmar/plantar metacarpal/metatarsal nerves. All images were assessed subjectively and a quantitative image analysis was performed by drawing a vertical line profile through the center of each joint in the lateral images and using region of interest analysis in both lateral and dorsal/plantar images. Ratios of radiopharmaceutical uptake were compared for each region between lame and contralateral limbs in unilaterally lame horses and between lame and control horses. There was a significant difference in the ratio of radiopharmaceutical uptake in the proximal aspect of the proximal phalanx between lame and nonlame forelimbs in unilaterally lame horses and in both lame and contralateral limbs of lame horses compared with control horses for the regions of the distal aspect of the third metacarpal/metatarsal bone and the proximal sesamoid bones. However, the profile analysis was of limited clinical value.  相似文献   

14.
OBJECTIVE: To evaluate the local analgesic effect of ketamine in a palmar digital nerve block at the base of the proximal sesamoid (abaxial sesamoid block) in horses. ANIMALS: 36 mature healthy Andalusian horses. PROCEDURE: Horses were randomly assigned to 4 groups of 9 horses each and received an abaxial sesamoid block in a randomly chosen forelimb with 1 of the following: saline (0.9% NaCl) solution, 1% ketamine solution, 2% ketamine solution, or 3% ketamine solution. To determine analgesia, the radiant heat lamp-hoof withdrawal model was used as a noxious thermal stimulus. Before each nerve block, baseline hoof withdrawal reflex latency (HWRL, time between lamp illumination and withdrawal of the hoof) was determined; after the nerve block, local analgesic effects were determined by measuring HWRL at 2 and 5 minutes after injection and then every 5 minutes for a total period of 1 hour. RESULTS: Significant differences in HWRL were found between baseline values and values at 2 to 15 minutes following a nerve block with ketamine. Significant differences were found between HWRL values at every time point from 2 to 10 minutes following a nerve block with saline solution, compared with 1 or 2% ketamine solution. Similarly, significant differences were found between HWRL values at every time point from 2 to 15 minutes following a nerve block with saline solution, compared with 3% ketamine solution. CONCLUSIONS AND CLINICAL RELEVANCE: Abaxial sesamoid block with ketamine ensures adequate analgesia in horses with an onset of action of 2 minutes and a maximal duration of action of 15 minutes.  相似文献   

15.
Reasons for performing study: Evidence‐based information is limited on distribution of local anaesthetic solution following perineural analgesia of the palmar (Pa) and palmar metacarpal (PaM) nerves in the distal aspect of the metacarpal (Mc) region (‘low 4‐point nerve block’). Objectives: To demonstrate the potential distribution of local anaesthetic solution after a low 4‐point nerve block using a radiographic contrast model. Methods: A radiodense contrast medium was injected subcutaneously over the medial or the lateral Pa nerve at the junction of the proximal three‐quarters and distal quarter of the Mc region (Pa injection) and over the ipsilateral PaM nerve immediately distal to the distal aspect of the second or fourth Mc bones (PaM injection) in both forelimbs of 10 mature horses free from lameness. Radiographs were obtained 0, 10 and 20 min after injection and analysed subjectively and objectively. Methylene blue and a radiodense contrast medium were injected in 20 cadaver limbs using the same techniques. Radiographs were obtained and the limbs dissected. Results: After 31/40 (77.5%) Pa injections, the pattern of the contrast medium suggested distribution in the neurovascular bundle. There was significant proximal diffusion with time, but the main contrast medium patch never progressed proximal to the mid‐Mc region. The radiological appearance of 2 limbs suggested that contrast medium was present in the digital flexor tendon sheath (DFTS). After PaM injections, the contrast medium was distributed diffusely around the injection site in the majority of the limbs. In cadaver limbs, after Pa injections, the contrast medium and the dye were distributed in the neurovascular bundle in 8/20 (40%) limbs and in the DFTS in 6/20 (30%) of limbs. After PaM injections, the contrast and dye were distributed diffusely around the injection site in 9/20 (45%) limbs and showed diffuse and tubular distribution in 11/20 (55%) limbs. Conclusions and potential relevance: Proximal diffusion of local anaesthetic solution after a low 4‐point nerve block is unlikely to be responsible for decreasing lameness caused by pain in the proximal Mc region. The DFTS may be penetrated inadvertently when performing a low 4‐point nerve block.  相似文献   

16.
Injection of local anaesthetic solution around the palmar nerves at the base of the proximal sesamoid bones is typically considered to desensitise structures distal to this location. There has been recent research investigating the potential for proximal diffusion of local anaesthetic solution resulting in desensitisation of structures other than those intended. This case series describes lame horses that respond to this block but have pathology within the suspensory ligament branches, the distal aspect of the third metacarpal bone and/or the proximal sesamoid bones as seen with high field magnetic resonance imaging.  相似文献   

17.
OBJECTIVE: To evaluate the effects of shock wave treatment on cutaneous nerve function, compared with the effects of local nerve block and sedation. ANIMALS: 18 clinically sound Swiss Warmbloods. PROCEDURE: Horses were randomly allocated to 3 groups and received different amounts and types of shock waves (extracorporeal shock wave treatment [ESWT] or radial pressure wave treatment [RPWT]). Horses were sedated with xylazine and levomethadone. Shock waves were applied to the lateral palmar digital nerve at the level of the proximal sesamoid bones on 1 forelimb. Skin sensitivity was evaluated by means of an electrical stimulus at the coronary band before and 5 minutes after sedation and at 4, 24, and 48 hours after application of ESWT or RPWT. On the contralateral forelimb, skin sensitivity was tested before and 10 minutes after an abaxial sesamoid nerve block. RESULTS: No significant changes in skin sensitivity were detected, regardless of the shock wave protocol applied. Mean reaction thresholds after sedation were more than twice the baseline thresholds. After the abaxial sesamoid block, no reaction was recorded in any of the horses. CONCLUSIONS AND CLINICAL RELEVANCE: Application of ESWT or RPWT to the palmar digital nerve had no effect on cutaneous sensation distal to the treated region for at least 2 days after application. The analgesic effect of sedation on reaction to electrical stimuli was distinct but varied among horses.  相似文献   

18.
Investigations of the equine peripheral vascular system have been constrained by the lack of a non-invasive method of examining the arteries and veins of the limbs of the conscious horse. Precise correlations were established between the gross anatomical features of the peripheral vessels and their B-mode sonographic appearance in each thoracic limb of 35 horses. A sonographic imaging protocol was established. Additional Doppler sonographic recordings defined the arterial waveforms and demonstrated that blood flow to the foot could be evaluated in the lateral proper digital artery, distal to the level of the coronary band. Valves (with 2-4 cusps) were identified in the lumina of the medial and lateral palmar common digital veins and those of the medial and lateral palmar proper digital veins. Spontaneous echo contrast, a smoke-like haze of echoic blood, was seen in the lateral and medial palmar common digital veins, the distal deep palmar venous arch and communicating branches, and the palmar proper digital veins, and occasionally seen in the distal deep palmar arterial arch and distal proper palmar digital arteries. The value of duplex sonography (B-mode and Doppler) for anatomical and physiological studies of the peripheral vasculature of the horse was clearly established. Such data could be applied to the investigation of diseases affecting the peripheral circulation.  相似文献   

19.
OBJECTIVE: To determine functional and morphologic changes in palmar digital nerves after nonfocused extracorporeal shock wave (ESW) treatment in horses. ANIMALS: 6 horses. PROCEDURES: The medial and lateral palmar digital nerves of the left forelimb were treated with nonfocused ESWs. The medial palmar digital nerve of the right forelimb served as a nontreated control nerve. At 3, 7, and 35 days after treatment, respectively, 2 horses each were anesthetized and nerves were surgically exposed. Sensory nerve conduction velocities (SNCVs) of treated and control nerves were recorded, after which palmar digital neurectomies were performed. Morphologic changes in nerves were assessed via transmission electron microscopy. RESULTS: Significantly lower SNCV in treated medial and lateral nerves, compared with control nerves, was found 3 and 7 days after treatment. A significantly lower SNCV was detected in treated medial but not lateral nerves 35 days after treatment. Transmission electron microscopy of treated nerves revealed disruption of the myelin sheath with no evidence of damage to Schwann cell bodies or axons, 3, 7, and 35 days after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Nonfocused ESW treatment of the metacarpophalangeal area resulted in lower SNCV in palmar digital nerves. This effect likely contributes to the post-treatment analgesia observed in horses and may result in altered peripheral pain perception. Horses with preexisting lesions may be at greater risk of sustaining catastrophic injuries when exercised after treatment.  相似文献   

20.
Digital semiological anesthesia in horses: Technique and elements of interpretation. Semiological anesthesia of the pes is used during examinations for lameness in horses. Recent research data on the distal digital, distal interphalangeal articular, and podotrochlear intrathecal nerve blocks indicate that they are less than specific when considered in isolation. They should be used in combination to localize pain in the pes. A positive response to anesthesia of the distal interphalangeal articulation could also indicate that the source of the pain was in the podotrochlear apparatus or the dorsal part of the sole. Podotrochlear anesthesia also anesthetizes the dorsal part of the sole and, later, the distal interphalangeal joint. Distal digital anesthesia affects a large palmar area of the hoof and extends dorsally. Overall, basic research provides little support for the practical uses of semiological blocks.  相似文献   

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