Is anaesthesia of the deep branch of the lateral plantar nerve specific for the diagnosis of proximal metatarsal pain in the horse?

G. Hinnigan; P. Milner; A. Talbot; E. Singer

doi:10.3415/VCOT-13-12-0146

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2014; 27(05): 351-357
DOI: 10.3415/VCOT-13-12-0146

Original Research

Schattauer GmbH

Is anaesthesia of the deep branch of the lateral plantar nerve specific for the diagnosis of proximal metatarsal pain in the horse?

Authors

G. Hinnigan

¹Dalehead Veterinary Group, Settle, North Yorkshire, UK
P. Milner

²Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Leahurst Campus, Neston, Wirral, UK
A. Talbot

³School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Wirral, UK
E. Singer

²Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Leahurst Campus, Neston, Wirral, UK

Abstract

Summary

Objectives: To investigate the specificity of anaesthesia of the deep branch of the lateral plantar nerve (DB-LPN).

Methods: Twenty horses had DB-LPN anaesthesia performed by a single injection technique as part of a lameness investigation. The mechanical nociceptive threshold (NT) was measured using a handheld force meter at six points on the lateral aspect of the limb: before diagnostic anaesthesia (T0), and at 15 (T15) and 30 (T30) minutes post anaesthesia. Paired t-tests were performed and significance was set at p <0.05. In addition, ten cadaveric limbs were injected with 2.5 ml new methylene blue solution using a single injection technique to evaluate the extent of dye diffusion within the proximal metatarsal region.

Results: Compared with T0, there was a significant decrease in NT for all points combined at T15 (p = 0.008) and also at T30 (p = 0.007). There was a significant decrease in NT at T15 on the lateral third metatarsal bone (p = 0.012). At T30 there was a significant decrease in NT at the lateral sesamoid (p = 0.007), lateral third metatarsal bone (p = 0.031), and mid metatarsus (p = 0.033). Four out of 20 horses had a NT greater than 10 N at the lateral heel bulb at T30. In the cadaveric limbs, the total diffusion distance for all limbs (mean ± SD) was 70.4 ± 20.5 mm. Dye surrounded the DB-LPN in all limbs and the lateral plantar nerve (LPN) in nine out of 10 limbs.

Clinical significance: Concurrent anaesthesia of the LPN is likely to occur when DBLPN anaesthesia is performed using a single injection technique.

Keywords

Horse - lameness - diagnostic anaesthesia - proximal suspensory desmitis - nociception

Full Text

References

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