The effect of lidocaine on postoperative jejunal motility in normal horses.
Authors: Milligan Melissa, Beard Warren, Kukanich Butch, Sobering Tim, Waxman Sarah
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Lidocaine and Post-operative Jejunal Motility in Horses Following surgical colic cases, clinicians often administer lidocaine in hopes of promoting return of normal intestinal function, yet this 2007 study questions whether that practice is justified in healthy horses. Researchers implanted electrodes directly onto the proximal jejunum of anaesthetised horses and recorded electrical activity at 24, 48, and 72 hours post-operatively, comparing a three-hour saline control period against a three-hour lidocaine infusion (1.3 mg/kg IV bolus followed by 0.05 mg/kg/min constant rate infusion). Whilst Phase III of the migrating myoelectric complex (MMC)—the forceful contraction phase responsible for clearing intestinal content—was significantly shortened during lidocaine administration (P=0.002), overall MMC duration remained unchanged (77 minutes with saline versus 105 minutes with lidocaine, P=0.16), and critically, neither spiking activity nor the frequency of Phase III events were affected across any time point. The authors conclude that lidocaine cannot be supported as a prokinetic agent in normal, healthy horses, though they acknowledge results might differ in clinical cases with compromised motility. For practitioners, this suggests that whilst lidocaine may serve other roles in post-operative management—analgesia, anti-inflammatory effects—assuming it will actively restore intestinal function in otherwise normal horses lacks empirical support.
Read the full abstract on PubMed
Practical Takeaways
- •Lidocaine may not reliably improve jejunal motility in healthy horses post-surgery; use of other prokinetic agents should be considered for post-operative ileus cases
- •While lidocaine shortened Phase III, this did not translate to increased overall gut activity, suggesting the clinical benefit for gut mobilization is questionable
- •Results are from normal horses only—clinical effectiveness may differ in horses with actual postoperative motility problems and should not be ruled out entirely
Key Findings
- •Lidocaine administration significantly shortened Phase III duration of the migrating myoelectric complex (P=0.002)
- •Overall MMC duration remained unchanged during lidocaine infusion (77 min saline vs 105 min lidocaine, P=0.16)
- •Spiking activity and number of Phase III events were unchanged across all three postoperative recording periods during lidocaine treatment
- •Lidocaine cannot be supported as a prokinetic agent in normal horses based on these results