Epidural anesthesia and analgesia in horses

Epidural anesthesia is a loco-regional anesthesia technique where drugs are injected in the epidural space. In the 19th century, this technique was developed for human medicine, and later found its way into veterinary medicine. It is useful for surgical interventions in the standing horse, as part of a balanced anesthetic protocol or for postoperative pain management. Analgesia and anesthesia involves the pelvis, pelvic limbs, tail, vagina, vulva, anus, perineum and abdomen. However, several contraindications and complications have been reported for epidural anesthesia. In horses, epidural injections can be performed cranially (lumbosacral space) or caudally (sacro-coccygeal or Co1-Co2). While single injections can be performed, the use of epidural catheters allows repeated administration. Depending on the desired effect, different drugs (local anesthetics, alpha2-agonists, opioids, ketamine, tramadol or tiletamine-zolazepam), drug combinationsd volumes can be chosen.