Unilateral cervical plexus block for prosthetic laryngoplasty in the standing horse.
Authors: Campoy L, Morris T B, Ducharme N G, Gleed R D, Martin-Flores M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Unilateral Cervical Plexus Block for Standing Laryngoplasty Roaring in horses is a significant performance limitation, yet traditional surgical correction of laryngeal hemiplegia requires general anaesthesia with its attendant risks. Campoy and colleagues investigated whether blocking the C2 and C3 spinal nerves—which supply sensory innervation to laryngeal structures—could provide sufficient analgesia to permit prosthetic laryngoplasty (tie-back surgery) under standing sedation rather than recumbency. The team developed and validated a unilateral cervical plexus block technique, demonstrating that selective nerve blockade could achieve adequate desensitisation of peri-laryngeal tissues whilst maintaining the horse's ability to remain standing throughout the procedure. This locoregional approach offers meaningful advantages: reduced anaesthetic risk, faster recovery, lower cost, and preservation of airway reflexes—particularly valuable for horses with concurrent respiratory disease or poor anaesthetic candidates. For practitioners involved in surgical management of laryngeal dysfunction, this technique expands the toolkit for safe, efficient correction of performance-limiting airway obstruction.
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Practical Takeaways
- •Standing laryngeal surgery is now feasible using cervical plexus blocks, eliminating general anesthesia risks in horses with poor prognosis for recovery
- •This technique provides an alternative for horses where recumbency poses safety concerns or where rapid return to function is critical
- •Practitioners should consider referral for standing prosthetic laryngoplasty in suitable candidates to improve surgical outcomes and reduce perioperative complications
Key Findings
- •Unilateral cervical plexus block (C2-C3) provides sensory anesthesia to peri-laryngeal structures in standing horses
- •This technique enables laryngeal lateralisation surgery (prosthetic laryngoplasty) under standing procedural sedation without general anesthesia
- •Locoregional anesthetic approach reduces risks and recovery time associated with general anesthesia for laryngeal surgery