Dural and deep cervical musculature anesthetic blockade for atlantoaxial collection of cerebrospinal fluid in horses.
Authors: Pereira Gabriella Faria, Fenelon Ana Carolina Guimarães, Horr Mônica, Nogueira Geison Morel, Delfiol Diego José Zanzarini
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Cerebrospinal fluid (CSF) analysis remains essential for diagnosing equine neurological conditions, and atlantoaxial puncture between C1 and C2 offers distinct advantages over traditional collection methods by allowing the procedure in standing, conscious horses whilst minimising blood contamination of samples. Researchers evaluated whether local dural blockade with lidocaine could improve tolerability and sample quality in ten healthy horses undergoing this technique, assessing pain responses, sensitivity, post-procedure swelling, temperature changes and ultrasonographic findings alongside physical, chemical and cytological CSF analysis. Lidocaine blockade effectively dampened the pain response associated with dural penetration, and all collected samples met quality standards with laboratory values consistent with published reference ranges; the procedure itself proved straightforward and safe to perform. A transient hyperthermia occurred in 75% of all horses (70% in the lidocaine group, 80% in controls) between 4–12 hours post-collection, though this resolved completely without intervention by 24 hours. For practitioners performing atlantoaxial CSF collection in standing horses, this work supports the use of dural infiltration anesthesia as a welfare-conscious refinement that reduces procedural discomfort without compromising diagnostic accuracy, whilst confirming that mild post-procedure fever is an expected and self-limiting response rather than a cause for concern.
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Practical Takeaways
- •Atlantoaxial CSF collection in standing horses is a practical alternative to general anesthesia methods, reducing contamination risk and procedure limitations
- •Local lidocaine dural blockade effectively mitigates the pain response during needle passage through dura, improving patient tolerance
- •Expect transient mild fever post-procedure (4-12 hours) in most patients—this is self-limiting and requires no intervention
Key Findings
- •Lidocaine dural blockade successfully reduced pain response during needle passage through the dura mater in atlantoaxial CSF collection
- •CSF samples obtained via atlantoaxial puncture showed satisfactory quality with laboratory results consistent with literature values
- •Transient hyperthermia occurred in 75% of all animals (70% dural blockade group, 80% control group), resolving spontaneously by 24 hours post-procedure
- •The atlantoaxial puncture procedure was safe and simple to perform in standing horses with minimal local tissue changes observed