Page 203 - Adams and Stashak's Lameness in Horses, 7th Edition

Examination for Lameness 169

Table 2.6. Guidelines for intrasynovial anesthesia.
VetBooks.ir Synovial cavity Needle size Volume of anesthetic Approaches and limb position (standing or held)

20–22 g, 1–1.5″
Dorsal approaches: standing
Coffin joint
4–5 mL
Lateral approach: standing or held
Pastern joint 20–22 g, 1.5″ 4–5 mL Dorsal and dorsolateral approaches: standing
Palmar/plantar approach: held
Fetlock joint 20–22 g, 1–1.5″ 8–12 mL Proximal palmar/plantar approaches: standing or held
Collateral sesamoidean approach: held
Distal palmar/plantar approach: standing
Dorsal approach: standing
Carpal joints 20–22 g, 1–1.5″ 8–10 mL Doral approaches: held
Palmar approaches: standing
Elbow 20 g, 1.5″ or 20 g, 3.5″ 20–30 mL All approaches: standing

Shoulder 18–20 g, 3.5″ 20–40 mL All approaches: standing
Tarsometatarsal joint 20 g, 1–1.5″ 4–6 mL All approaches: standing
Distal intertarsal joint 25 g, 5/8″ or 22 g, 1″ 3–5 mL All approaches: standing

Tarsocrural joint 20–22 g, 1.5″ 15–20 mL All approaches: standing
Femoropatellar joint 20 g, 1.5–3.5″ 30–40 mL All approaches: standing
Medial femorotibial joint 20 g, 1.5″ 20–30 mL All approaches: standing
Lateral femorotibial joint 20 g, 1.5″ 20–30 mL All approaches: standing
Coxofemoral joint 16–18 g, 6–8″ spinal 30–60 mL All approaches: standing

Sacroiliac joint 15–16 g, 10″ spinal 7–10 mL All approaches: standing
Digital flexor tendon sheath 20–22 g, 1–1.5″ 8–15 mL Proximal approach: standing
All other approaches: held
Carpal sheath 20 g, 1.5–3.5″ 15–30 mL Medial approach: standing
Lateral approach: held
Tarsal sheath 20 g, 1.5″ 15–20 mL Medial approach: standing
Extensor carpi radialis sheath 20 g, 1.5″ 10–20 mL All approaches: standing or held
Calcaneal bursa 20 g, 1.5″ 10–15 mL Distal approach: standing
Proximal approach: standing or held
Bicipital bursa 18–20 g, 3.5–5″ or 20 g, 1.5″ 20–30 mL All approaches: standing
Trochanteric bursa 18–20 g, 1.5–3.5″ 7–10 mL All approaches: standing
Cunean bursa 20–22 g, 1″ 2–3 mL Medial approach: standing

To improve the selectivity of DIP joint anesthesia, a (Figure 2.164; Video 2.18). Local anesthesia at the site of
maximum of 5–6 mL of anesthesia is recommended, and the injection or perineural anesthesia above the heel
assessment of the block should be performed within 10 bulbs may be used to provide skin analgesia prior to the
minutes of injection. 63,66 injection. The needle is advanced along a sagittal plane
aiming for a point 1 cm below the coronary band, mid­
60
Podotrochlear (Navicular) Bursa way between the toe and the heel. The needle is
advanced until bone is contacted. Only 2–4 mL or anes­
The traditional approach to access the navicular bursa thetic or medication can usually be injected, and flexing
is through the heel bulbs. 51,60,62,66 With this approach, a the lower limb will usually decrease the resistance to
18‐20‐gauge, 3.5‐inch (8.9‐cm) spinal needle is inserted injection. Some clinicians prefer to use a special wooden
between the heel bulbs just above the coronary band block that unweights the heel and flexes the distal limb to