Effect of Emptying the Vasculature Before Performing Regional Limb Perfusion with Amikacin in Horses

Equine Veterinary Journal recently published an article titled, “Effect of emptying the vasculature before performing regional limb perfusion with amikacin in horses” on wiley.com. You may purchase or lease this article from that website.


Reasons for performing study

Emptying the vasculature with an Esmarch bandage before intravenous regional anaesthesia is commonly performed in humans to prevent leakage of the solution under the tourniquet but there is no evidence for its efficacy in horses for antimicrobial intravenous regional limb perfusion (IV-RLP).


To determine the effect of emptying the vasculature before performing the IV-RLP on synovial fluid concentration of amikacin.

Study design

Cross-over experiment.


Eight clinically healthy horses underwent two IV-RLP with amikacin in a randomised, cross-over design. Horses received an IV RLP with amikacin with or without exsanguination before applying a pneumatic tourniquet at the level of the forearm. Blood was collected from the jugular vein (before tourniquet removal) and synovial fluid from the radiocarpal and metacarpophalangeal joints (5 minutes after tourniquet removal and at 24 hours) for amikacin determination. The procedure was video recorded to assess horse movement.


There was no difference on amikacin concentrations in the plasma or synovial fluid from the radiocarpal joint between groups. There was higher concentration of amikacin in the synovial fluid from the metacarpophalangeal joint immediately after tourniquet removal in the group with exsanguination of the limb prior to IV-RLP (mean ± s.d. 49.7 ± 53.7 μg/mL, 257.4 ± 149.7 μg/mL, p = 0.04). Horse movement did not differ significantly between groups.


Emptying the vasculature with an Esmarch bandage before IV-RLP can improve amikacin concentrations in the metacarpophalangeal joint of horses with no effect in the levels of amikacin in the radiocarpal joint.


A. Sole and F.A. Aristizabal, William R. Pritchard Veterinary Medical Teaching Hospital’ J.E. Nieto and J.R. Snyder, Departments of Surgical and Radiological Sciences, University of California, Davis.

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