Standing internal fixation should be performed in a clean room where the environment can be kept quiet. The horse should be groomed and/or bathed before the procedure. Skin preparation is routine. An attendant should be with the horse’s head at all times.
2. Sedation and local anesthesia
Sedation will vary according to the temperament of the horse. Many surgeons prefer a constant rate infusion of detomidine (or similar agent). Another option is a combination of an alpha2-agonist and an opiate. Local anesthesia should be an extensive infiltrative block just distal to the carpus or tarsus. The block should be done only after the horse is sedated and positioned in the surgery room, preferably in stocks.
Draping must include impervious materials to cover the floor. Transparent adhesive drapes are very useful to cover the limb above the surgical site.