Anaesthetic & analgesic regime for digit amputation

Question 1

Anaesthesia for digit amputation

Answer 1

IV regional anaesthesia:
- torniquet (stays on for full length of time to get anaesthesia i.e. 10-15mins)
- Check interdigital skin for if its worked – last place to anaesthetise so dig needle in to see if there’s a response

Procaine
– ring block or 4-point nerve block and local anaesthetic into the palmer/plantar pastern region
- Only licenced product available in the UK for food producing animals. - First product of choice for a ring block

4-point nerve block
- gets digital nerves 2&3

Ring block
- doesn’t get as deep as anaesthesia as IVRA, but good if swollen leg and so hard to find vein

Xylazine if fractious animal

Question 2

Analgesia for digit amputation

Answer 2

• NSAIDs used to prevent wind-up -> sensitivity and pain levels
• Can be beneficial for the treatment of claw horn disruption lesions and minimise periosteal inflammation and new bone formation on the plantar/palmar aspect of the flexor tuberosity of the distal phalanx
• Any NSAID (ketoprofen, meloxicam, carprofen, flunixin) would be effective.
• Normally give 1 off dose, but for digit amp 3-5 repeat doses
• Ketoprofen
  – has 0d milk withdrawal period but only licenced for use for up to 3d
  – Needs to be repeated every 24h
  – Can be given IM so farmer is able to administer repeat doses.

Question 3

Antibiotic use for digit amputation

Answer 3

• depends on the case
• normally ascending infection for these cases so give pre-op antibiotics (amoxicillin good)
• P3 fracture not healing
• if surgery done aseptically may not give antibiotics
• Most cases would give ABs.