Transdermal Application of Anesthetic Preparations Is Effective in Increasing Mechanical Nociceptive Threshold at Perineural Injection Sites in Horses.
Authors: Pagliara Eleonora, Nicolo Alice, Rossi Carmen, Cammaresi Claudio, Donadio Gianmichele, Bertuglia Andrea
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Perineural nerve blocks are fundamental to equine lameness diagnosis, yet the injection procedure itself can provoke painful reactions that compromise safety for both horse and veterinarian. Pagliara and colleagues investigated whether two commonly used topical anaesthetic preparations—EMLA and PLIAGLIS—could effectively desensitise injection sites prior to perineural anaesthesia, using a randomised, blinded design with 14 healthy horses (seven per treatment group) and measuring mechanical nociceptive threshold via pressure algometry at baseline and one hour post-application. Both formulations significantly increased nociceptive threshold at the injection sites themselves, with no meaningful difference between the two products, whilst importantly showing no systemic analgesic effects on distal sites such as the coronary band or heel bulbs. For practitioners, this confirms that topical anaesthetic cream applied one hour before perineural injection can meaningfully reduce the horse's painful response to needle penetration, thereby improving procedural safety and potentially reducing movement artefacts during diagnostic blocks—though the choice between EMLA and PLIAGLIS appears immaterial from an efficacy standpoint.
Read the full abstract on PubMed
Practical Takeaways
- •Apply topical anesthetic cream to perineural injection sites 1 hour before performing nerve blocks to significantly reduce injection-related pain and improve safety for veterinarians
- •Either EMLA or PLIAGLIS can be used interchangeably—choose based on availability and cost, as both are equally effective for skin desensitization
- •These topical preparations only desensitize the skin surface at application sites and will not provide anesthesia for deeper tissues or distal structures during lameness examinations
Key Findings
- •Both EMLA and PLIAGLIS topical anesthetic creams significantly increased mechanical nociceptive threshold at perineural injection sites one hour after application
- •No significant difference in efficacy between EMLA and PLIAGLIS formulations for skin desensitization
- •Topical anesthetic application did not affect mechanical nociceptive threshold at distal sites (coronary band, heel bulbs)
- •Skin desensitization was superficial and localized to treated areas without systemic analgesic effects