Langford Vets Equine Hospital, Langford, Bristol BS40 5DU, UK.
Can Vet J. 2024 Aug;65(8):808-812.
To determine with mechanical nociceptive threshold (MNT) testing whether distal limb skin sensation is affected by intra-articular anesthesia of the tarsometatarsal joint (TMTJ).
This was a prospective cohort study. Ten client-owned horses that had intra-articular TMTJ anesthesia were included in the study. The MNT was measured at 6 sites on the distal limb at 3 time points: before anesthesia (T0) and at 10 min (T10) and 30 min (T30) post-injection. Linear mixed-model analyses were done, with the significance level set at < 0.05.
There was an increase in MNT ( = 0.001) across combined testing points between T0 and T30, indicating loss of skin sensation in the distal limb 30 min after TMTJ anesthesia. Regarding individual MNT sites, there were increases at the lateral proximal sesamoid bone ( = 0.002) and dorsal coronary band ( = 0.037) at T30 compared to T0.
Intra-articular anesthesia of the TMTJ significantly increased the combined MNT of the skin of the distal limb at 30 min, indicating decreased skin sensation.
Diagnostic anesthesia of the distal hind limb should be performed before TMTJ block. However, if patient compliance prevents this, lameness evaluation 10 min after blocking may enhance the reliability of interpretation.
通过机械性伤害感受阈值（MNT）测试，确定跗跖关节（TMTJ）关节内麻醉是否会影响远肢皮肤感觉。
这是一项前瞻性队列研究。研究纳入了 10 匹接受 TMTJ 关节内麻醉的患畜。在 3 个时间点（麻醉前（T0）和注射后 10 分钟（T10）和 30 分钟（T30）），在远肢的 6 个部位测量 MNT。使用线性混合模型分析，显著性水平设为 < 0.05。
与 T0 相比，T0 与 T30 之间各联合检测点的 MNT 增加（= 0.001），表明 TMTJ 麻醉后 30 分钟远肢皮肤感觉丧失。关于个体 MNT 部位，与 T0 相比，T30 时外侧近籽骨（= 0.002）和背侧冠状带（= 0.037）的 MNT 增加。
TMTJ 关节内麻醉显著增加了远肢皮肤的联合 MNT，表明皮肤感觉下降。
在进行 TMTJ 阻滞之前，应进行远后肢的诊断性麻醉。但是，如果患者不配合，那么在阻滞后 10 分钟进行跛行评估可能会增强解释的可靠性。
