Multimodal perioperative pain management in a horse undergoing partial phallectomy

Abstract

A well-balanced multimodal pain management including local anaesthetic techniques was used to provide perioperative analgesia in a horse undergoing partial phallectomy. This surgical intervention has been associated with moderate to severe pain and may present additional challenges to the veterinarian when providing pain relief postoperatively.In the present case, preoperative analgesia included morphine and flunixin meglumine, both intravenously. Throughout surgery, adaptable constant rate infusions (CRIs) with ketamine and xylazine were supplemented to address different receptors of the pain pathway. Additionally, a pudendal nerve block with ropivacaine was added intraoperatively to reduce nociception and decrease sensitisation of the central nervous system. An epidural injection of morphine and dexmedetomidine was performed after recovery from general anaesthesia. Postoperative pain treatment included morphine and flunixin meglumine that resulted in adequate pain relief, based on pain assessment every 6–12 hours. Neither side effects nor complications were observed during the hospital stay.