Equine Standing sedation

Question 1

How is a balanced approach to standing sedation achieved?

Answer 1

By supplementing sedatives and tranquilizers with systemic analgesic or regional anesthetic

Question 2

What drug class is the main stem component of any standing sedation in horses?

Answer 2

Alpha 2s

Question 3

What are some examples of Alpha-2s used in standing horse sedation?

Answer 3

Xylazine
Romifidine
Detomidine
Dexmedetomidine

Question 4

What is the peak effect of IV administered Alpha-2s?

Answer 4

2 to 5 minutes

Question 5

What is the peak effect of IM administered Alpha-2s?

Answer 5

15 to 30 minutes

Question 6

All Alpha 2’s produces what?

Answer 6

Reliable, sedative, visceral and somatic analgesic and muscle relaxant

Question 7

What are the side effects of Alpha-2 administration?

Answer 7

Bradycardia
2nd degree AV block
Biphasic hypertension followed by hypotension
Increased urine production
Moderate hyperglycemia
Sweating
Decreased GI motility

Question 8

What class of drugs are used synergistically with Alpha-2s

Answer 8

Opioids

Question 9

What are some examples of opioids?

Answer 9

Butorphanol
Morphine
Buprenorphine
Methadone

Question 10

What are some side effects of opioids used in standing sedation of horses?

Answer 10

Excitment
GI hypomotility
Histamine Release causing urticaria and hypotension (espically with merperidine)

Question 11

What other drug can be administered at sub-anesthetic doses to provide analgesiaL

Answer 11

Ketamine

Question 12

What drug is administered systemically to provide analgesia, and sedation, along with anti-inflammatory, prokinetic, and anti-endotoxemic effects?

Answer 12

Lidocaine

Question 13

What is the main nerve involved in blocking a horses’ mouth?

Answer 13

The Trigeminal nerve

Question 14

What are the 3 branches of the trigeminal nerve?

Answer 14

Ophthalamic area
Maxillary area
Mandibular area

Question 15

What dental structures are blocked when a maxillary nerve block is performed?

Answer 15

Maxilla
Premaxilla
Paranasal sinuses
Nasal cavity

Question 16

Where do you insert the needle for a maxillary nerve block?

Answer 16

Just ventral to the zygomatic process and dorsal to the transverse facial vessels

Question 17

What dental structures are blocked when a mandibular nerve block is performed?

Answer 17

Ipsilateral side of the mandible and all of its dental structures are blocked

Question 18

Where is the needle inserted when performing a mandibular nerve block?

Answer 18

At the ventral border of the Ramus of the mandible and advanced dorsally toward the mandibular foramen

Question 19

What dental structures are blocked when the Mental nerve block is performed?

Answer 19

Ipsilateral side of the rostral mandible, canine and incisor teeth and lower lip

Question 20

Where is the needle inserted to perform a mental nerve block?

Answer 20

As the nerve exits the mental foramen, the lateral side of the mandible, rostral to the 1st cheek tooth

Question 21

What structures are blocked when the infraorbital nerve block is used?

Answer 21

Skin of the ipsilateral lip, nostril, and face up to the level of the infraorbital canal

Question 22

Where is the needle inserted to perform an infraorbital nerve block?

Answer 22

As the nerve exits the infraorbital foramen, lies beneath levator labii superioris muscle

Question 23

What does a tooth root infection cause?

Answer 23

Unilateral nasal discharge

Fluid line on radiographs

Question 24

What is a standing maxillary bone flap used to treat?

Answer 24

Secondary sinusitis