Local anesthesia associated with cutaneous biopsy in veterinary medicine: a narrative review
DOI:
https://doi.org/10.33448/rsd-v11i16.37683Keywords:
Veterinary dermatology; Anesthetic toxicity; Punch biopsy; Lidocaine.Abstract
Skin biopsies, especially by punch, are widely used as a diagnostic tool in veterinary dermatology. It can be performed in patients under general anesthesia combined or not with local anesthesia, and in some cases, with local anesthesia alone. Lidocaine is the most widely used local anesthetic due to its rapid onset of action, easy to access and relatively inexpensive cost. Infiltrative anesthesia is often used in dermatological procedures, but regional anesthesia and topical anesthesia may also be recommended in some cases. Adverse effects vary from uncommon to rare and include local reactions such as local nerve lesions and hypersensitivity or contact dermatitis, and systemic reactions namely anaphylaxis, cardiotoxicity, and central nervous system depression. When administered at the appropriate dose for the referred species, with standardized technique and anatomical knowledge, adverse reactions are extremely rare. Local anesthetics are of fundamental importance for veterinary dermatology, especially in skin biopsy of dogs and cats. The aim of this narrative review, is to explore the structure and mechanism of action of the main drugs used, local anesthesia techniques, as well as possible side effects associated with the use of these drugs in dermatological surgeries, with focus on skin biopsies.
References
Abimussi, C. J., Menegheti, T. M., Wagatsuma, J. T., Floriano, B. P., Arruda, A. M., dos Santos, P. S., & Oliva, V. N. (2014). Tumescent local anesthesia with ropivacaine in different concentrations in bitches undergoing mastectomy: Plasma concentration and post-operative analgesia. Veterinary Anaesthesia and Analgesia, 41(5), 516-525. https://doi.org/10.1111/vaa.12178
Bahar, E., & Yoon, H. (2021). Lidocaine: A Local Anesthetic, Its Adverse Effects and Management. Medicina, 57(8), 782. https://doi.org/10.3390/medicina57080782
Butler, A., Hall, H., & Copnell, B. (2016). A guide to writing a qualitative systematic review protocol to enhance evidence‐based practice in nursing and health care. Worldviews on Evidence‐Based Nursing, 13(3), 241-249. https://doi.org/10.1111/wvn.12134
Canavari, I. C., Hernandez, G. V., Costa, M. T., & Camplesi, A. C. (2017). Doenças Dermatológicas de Caráter Zoonótico. Investigação, 16(1), 18-24.
Caubet, L. F. (2022). Diagnóstico histopatológico em dermatologia: como obter os melhores resultados em biopsias cutâneas. Boletim Derma Experience. https://www.zoetis.com.br/especies/animais-de-companhia/dezenvolve/pdf/technical-bulletin-derma-experience-n2-by-lluis-ferrer-brasil.pdf
Cepeda, M. S., Tzortzopoulou, A., Thackrey, M., Hudcova, J., Arora Gandhi, P., & Schumann, R. (2010). Adjusting the pH of lidocaine for reducing pain on injection. Em The Cochrane Collaboration (Org.), Cochrane Database of Systematic Reviews (p. CD006581.pub2). John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.CD006581.pub2
Cherobin, A. C. F. P., & Tavares, G. T. (2020a). Safety of local anesthetics. Anais Brasileiros de Dermatologia, 95(1), 82-90. https://doi.org/10.1016/j.abd.2019.09.025
Correia, A. M. R., & Mesquita, A. (2014). Mestrados E Doutoramentos. Porto:Vida Econômica Editorial, 328 p.
Craig, M. (2007). Skin biopsies in veterinary dermatology. Companion Animal, 12(7), 68-71. https://doi.org/10.1111/j.2044-3862.2007.tb00204.x
Day, T. K., & Skarda, R. T. (1991). The Pharmacology of Local Anesthetics. Veterinary Clinics of North America: Equine Practice, 7(3), 489–500. https://doi.org/10.1016/S0749-0739(17)30482-0
Dewangan, R., & Tiwari, S. K. (2019). Physiology of pain and its management in veterinary patients. Pharma Innova J, 8(11), 68-78.
Douglas, H., Welsh, S., & Barr, C. (2021a). Clinical techniques in veterinary dermatology: Regional anaesthesia of the canine and feline distal limb. Veterinary Dermatology, 32(1), 90-e17. https://doi.org/10.1111/vde.12916
Erkert, R. S., Macallister, C. G., Campbell, G., Payton, M. E., Shawley, R., & Clarke, C. R. (2005). Comparison of topical lidocaine/prilocaine anesthetic cream and local infiltration of 2% lidocaine for episioplasty in mares. Journal of Veterinary Pharmacology and Therapeutics, 28(3), 299-304. https://doi.org/10.1111/j.1365-2885.2005.00657.x
Evers, A. S., Maze, M., & Kharasch, E. D. (Orgs.). (2011). Anesthetic Pharmacology (2o ed). Cambridge University Press. https://doi.org/10.1017/CBO9780511781933
Grimm, K. A., Lamont, L. A., Tranquilli, W. J., Greene, S. A., & Robertson, S. A. (Orgs.). (2015). Veterinary anesthesia and analgesia (Fifth edition). Wiley Blackwell.
Grimm, K., & Tranquilli, W. (2017). Lumb & Jones. Grupo Gen - Editora Roca Ltda. https://public.ebookcentral.proquest.com/choice/publicfullrecord.aspx?p=4979457
Grubb, T., & Lobprise, H. (2020a). Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Veterinary Medicine and Science, 6(2), 209-217. https://doi.org/10.1002/vms3.218
Grubb, T., & Lobprise, H. (2020b). Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1). Veterinary Medicine and Science, 6(2), 218-234. https://doi.org/10.1002/vms3.219
Henfrey, J. I., Thoday, K. L., & Head, K. W. (1991). A Comparison of Three Local Anaesthetic Techniques for Skin Biopsy in Dogs. Veterinary Dermatology, 2(1), 21-27. https://doi.org/10.1111/j.1365-3164.1991.tb00106.x
Hill, P. B., Lo, A., Eden, C. A. N., Huntley, S., Morey, V., Ramsey, S., Richardson, C., Smith, D. J., Sutton, C., Taylor, M. D., Thorpe, E., Tidmarsh, R., & Williams, V. (2006). Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice. Veterinary Record, 158(16), 533–539. https://doi.org/10.1136/vr.158.16.533
Hnilica, K. A., & Medleau, L. (2011). Small animal dermatology: A color atlas and therapeutic guide (3rd ed). Elsevier/Saunders.
Ko, J. C. H., Maxwell, L. K., Abbo, L. A., & Weil, A. B. (2008). Pharmacokinetics of lidocaine following the application of 5 lidocaine patches to cats. Journal of Veterinary Pharmacology and Therapeutics, 31(4), 359–367. https://doi.org/10.1111/j.1365-2885.2008.00967.x
Lemo, N., Vnuk, D., & i Banović, F. (2015). Observation of potential lidocaine toxicity during local anesthesia administration for punch skin biopsy in dogs. Veterinarski arhiv, 85(5), 523-532. https://hrcak.srce.hr/148013
Liu, S., Carpenter, R. L., Chiu, A. A., McGill, T. J., & Mantell, S. A. (1995). Epinephrine prolongs duration of subcutaneous infiltration of local anesthesia in a dose-related manner:: Correlation with magnitude of vasoconstriction. Regional Anesthesia and Pain Medicine, 20(5), 378-384.
Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., Wright, B., & Yamashita, K. (2014). Guidelines for Recognition, Assessment and Treatment of Pain: WSAVA Global Pain Council members and co-authors of this document: Journal of Small Animal Practice, 55(6), E10–E68. https://doi.org/10.1111/jsap.12200
Matsumoto, A. H., Reifsnyder, A. C., Hartwell, G. D., Angle, J. F., Selby, J. B., & Tegtmeyer, C. J. (1994). Reducing the Discomfort of Lidocaine Administration through pH Buffering. Journal of Vascular and Interventional Radiology, 5(1), 171–175. https://doi.org/10.1016/S1051-0443(94)71478-0
Mccoy, A., Schaefer, E., Malone, E. (2007). How to perform effective block of the equine ear. Proceedings of the 53rd Annual Convention of the American
Association of Equine Practitioners Convention, 53, 397-398. https://www.cabdirect.org/cabdirect/abstract/20083097745
Miller, W. H., Griffin, C. E., Campbell, K. L., Muller, G. H., & Scott, D. W. (2013). Muller & Kirk’s small animal dermatology. http://site.ebrary.com/id/10726672
Pye, C. (2019). The art of skin biopsy. World Small Animal Veterinary Association Congress Proceedings, 1, 1 Toronto. https://www.vin.com/apputil/content/defaultadv1.aspx?pId=24437&catId=137430&id=9382911&ind=78&objTypeID=17 >
Rainger, J., Baxter, C., Vogelnest, L., & Dart, C. (2009). Seizures during medetomindine sedation and local anaesthesia in two dogs undergoing skin biopsy. Australian Veterinary Journal, 87(5), 188-192. https://doi.org/10.1111/j.1751-0813.2009.00419.x
Re Bravo, V., Aprea, F., Bhalla, R. J., De Gennaro, C., Cherubini, G. B., Corletto, F., & Vettorato, E. (2019). Effect of 5% transdermal lidocaine patches on postoperative analgesia in dogs undergoing hemilaminectomy. Journal of Small Animal Practice, 60(3), 161–166. https://doi.org/10.1111/jsap.12925
Reader, R. C., McCarthy, R. J., Schultz, K. L., Volturo, A. R., Barton, B. A., O’Hara, M. J., & Abelson, A. L. (2020). Comparison of liposomal bupivacaine and 0.5% bupivacaine hydrochloride for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy. Journal of the American Veterinary Medical Association, 256(9), 1011–1019. https://doi.org/10.2460/javma.256.9.1011
Reuss-Lamky, H. (2020). Locoregional anestesia for small animal patient. Todays Veterinary Nurse. https://todaysveterinarynurse.com/pain-management/locoregional-anesthesia-for-small-animal-patients/
Robertson, S. A. (2005). Assessment and management of acute pain in cats. Journal of Veterinary Emergency and Critical Care, 15(4), 261-272 https://doi.org/10.1111/j.1476-4431.2005.00172.x
Seltzer, J. D. (2007). Skin biopsies in mammals. Lab Animal, 36(4), 23–24. https://doi.org/10.1038/laban0407-23
Steagall, P. (2015). Local Anesteshia. World Small Animal Veterinary Association World Congress Proceedings, 2015.
https://www.vin.com/apputil/content/defaultadv1.aspx?id=7259411&pid=14365>.
Tomich, L. M., Keating, S. C. J., Allender, M. C., & Pieper, J. B. (2021). The effect of topical lidocaine on intradermal testing in atopic dogs. Veterinary Dermatology, 32(2), 139. https://doi.org/10.1111/vde.12923
van Oostrom, H., & Knowles, T. G. (2018). The clinical efficacy of EMLA cream for intravenous catheter placement in client-owned dogs. Veterinary Anaesthesia and Analgesia, 45(5), 604–608. https://doi.org/10.1016/j.vaa.2018.03.009
Veres‐Nyéki, K. O. (2021). Clinical techniques in veterinary dermatology Regional anaesthesia of the canine and feline nose. Veterinary Dermatology, vde.13050, 258-262. https://doi.org/10.1111/vde.13050
Weiland, L., Croubels, S., Baert, K., Polis, I., De Backer, P., & Gasthuys, F. (2006). Pharmacokinetics of a Lidocaine Patch 5% in Dogs. Journal of Veterinary Medicine Series A, 53(1), 34–39. https://doi.org/10.1111/j.1439-0442.2006.00778.x
Welch, S. L. (2000). Local anesthetic toxicosis. Veterinary Medicine, 95(9), 670-673. https://aspcapro.org/sites/default/files/toxbrief_0900.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Keylla Hörbe Steffen dos Santos; Mariana Miranda de Souza Silva; Gabriela Reis Ledur; Daniel Guimarães Gerardi; João Roberto Braga de Mello
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.