Local analgesia techniques for dental and head procedures in horses

In equine first‐opinion and referral practice, diagnostic and treatment procedures involving the head and dentition are often performed with the animal conscious and sedated in a standing position. To enable such tasks to be performed safely, humanely and effectively, regional analgesia can be helpful, if not essential, in many cases. With the risk of injury to equine clinicians being of concern, a more scientific and rational approach than has been practised historically is now required. Over the past 20 years there have been a number of scientific articles in the literature describing and validating the use of different sedative–analgesic combinations that enable surgical and dental procedures of an advanced nature to be performed safely and effectively in conscious horses in the standing position. Allied to these, there have been descriptions of effective regional analgesia in the head and the development of some new techniques for its application. This article describes these approaches for those intending to perform painful procedures, such as dental, ophthalmic and paranasal sinus treatments, on a conscious horse.