• At the level of the junction of the proximal and middle thirds of the metacarpus (forelimb) or metatarsus (hind limb). B342.16.w16; J234.12.w2)
• Inject local anaesthetic solution at several sites around the leg: 
  • deep and superficial to the flexor tendons (adjacent to the deep and superficial flexor tendons);
  • medially and laterally to the extensor tendons, forming part of a circle around the leg.

  (B342.16.w16; J234.12.w2)

To provide local analgesia of the foot of sheep: 

• In addition to a ring block proximal to the fetlock, infiltrate local anaesthetic solution into the interdigital area. (J234.6.w1)

• Many veterinary practitioners consider that this is the most reliable method to produce regional analgesia of the lower limb. (B121.12.w12; B342.16.w16)

• The analgesic technique chosen should be decided based on the procedure to be undertaken, the facilities available and the skills of the practitioner. (J215.7.w1)
• Standard aseptic techniques should be practiced when performing local analgesia, including surgical preparation of the skin, and sterile injection techniques. (J215.7.w1)
• Aspiration to check for blood should be carried out prior to injection, to avoid inadvertent intravenous injection. (J215.7.w1)
• Epinephrine (adrenaline) at 1 part per 200,000 or norepinephrine (noradrenaline) at 1 part per 100,000 may be added to the local anaesthetic solution to decrease the absorption of the agents and prolong their action. These vasopressors should not be used for analgesia of appendages such as the tail, teats or toes as they may produce sufficient circulatory compromise of the appendage to result in tissue necrosis and sloughing. (J215.7.w1)
• Hyaluronidase may be added to local anaesthetic solutions to increase tissue permeability and thus decrease the time to onset of analgesia and reduce the volume of local anaesthetic solution required; it will also reduce the duration of analgesia. However it is questionable whether it is needed other than with procaine hydrochloride solution, since other local anaesthetic agents, such as lidocaine, penetrate tissues adequately. If used, then 150 turbidity reducing units (TRUs) of hyaluronidase may be added per 25 mL of 2% lidocaine. Combining both adrenaline and hyaluronidase with local anaesthetic solution may both increase initial spread and onset while also reducing uptake and therefore prolonging anaesthesia. Note: Use of hyaluronidase is NOT a substitute for accurate placement of local anaesthetic solution, since the tissue fascial planes will still act as barriers. (B342.16.w16)

• If local anaesthetic solution containing adrenaline is used there is a risk of tissue ischaemia caused by the vasoconstrictive effect of the adrenaline on local blood vessels. (B322.5.w5)
• This method is less precise than blockage of individual nerves. (B205.12.w12)
• Multiple injection sites are required, increasing the risk for introduction of pyogenic bacteria. (B342.16.w16; J234.12.w2)
• This method is not always successful. (B342.16.w16; J234.12.w2)

• Local anaesthetic solution without adrenaline.
  • 2% lidocaine (B342.16.w16; J15.19.w1)
    • 10 to 15 mL for cattle, 3.0 to 5.0 mL for a sheep or goat. (J234.12.w2)
• 2.5 cm 25-gauge needle (B342.16.w16; J234.12.w2).
• Syringe. 

• Less skill is required than for blockage of individual nerves, since precise anatomic knowledge of the limb is not required. (B342.16.w16; J234.12.w2)

• Inexpensive.