The effect of intra-articular mepivacaine administration prior to carpal arthroscopy on anesthesia management and recovery characteristics in horses.

Objective To evaluate the effects of intra-articular (IA) mepivacaine administration prior to carpal arthroscopy on anesthetic drug requirements, blood pressure support, hemodynamic variables, and quality of recovery in horses. Study design Experimental, analytical, cohort study. Sample population Twenty-two horses (n = 11 horses/group). Methods Horses were anesthetized by using the same protocol, but an IA injection of mepivacaine or saline was performed before carpal arthroscopy. End-tidal isoflurane concentration, heart rate, and mean arterial pressure were recorded at specific time points. Quality of recovery was scored by the anesthetist, who was unaware of group assignment. Data were analyzed by using two-way repeated-measures analysis of variance. Results Mean arterial pressure was higher during joint distension in the control group compared with baseline (7% higher,P= .02) and with the treatment group (10% higher,P= .04). Heart rate was higher in the control group compared with the treatment group during joint distension (8% higher,P= .04) and chip removal (11% higher,P= .03). Heart rate was higher in the control group compared with baseline during chip removal (5.5% higher,P= .04). Two horses in the control group required additional ketamine vs none in the treatment group. Quality of recovery was not different between groups. Conclusion Intra-articular mepivacaine resulted in fewer detectable reactions to surgical stimulation, with similar recovery scores and blood pressure support requirements. Clinical significance Intra-articular anesthesia prior to arthroscopy can be used safely in the horse and should be considered as a part of balanced anesthetic protocols.