Diagnostic anaesthesia: What’s the point?
Lameness cases represent a large proportion of first-opinion and referral equine practice. Diagnostic anaesthesia remains the mainstay of the lameness workup; however, recent work has highlighted a lack of specificity for perineural and intrasynovial nerve blocks. The specificity of diagnostic intrasynovial anaesthesia in the horse has previously been evaluated in the navicular bursa, distal interphalangeal joint, and digital flexor tendon sheath. Recently, intrasynovial anaesthesia of the stifle joint, tarsometatarsal (TMT) joint, and carpal sheath was reported to reduce skin sensation of the distal limb and foot. The effects of perineural anaesthesia of the deep branch of the lateral plantar nerve (DBLPN) on distal limb skin sensation have also been investigated, with DBLPN anaesthesia inadvertently desensitising the lateral plantar nerve in a proportion of horses.
- •To review recent literature regarding diagnostic anaesthesia in horses, categorized by anatomical region.
- •To highlight specific intrasynovial and perineural blocks where anatomical overlap and diffusion occur.
- •To discuss the clinical implications of these findings for lameness evaluation.
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