There are several varieties of chutes available to physically restrain llamas that will make physical examination much more acceptable to all involved.
Chemical restraint is a viable option to consider for a variety of procedures.
A fecal is important for identification of the problem and to estimate the parasite load.
Most llamas can be easily taught to halter lead and this should begin at an early age (4-8 months).
Juvenile llamas can be restrained by either cradling them in arms or physically holding them down in lateral recumbency.
Straddling these animals while in the cush position can also be an effective restraint technique.
Regarding local anaesthetic/analgesic techniques, it is important to note the sensitivity of alpacas to lignocaine.
As described in caesarian section of sheep and goats, dilution of 2% lignocaine 1:1 with sterile water can allow distribution in an inverted-L block without reaching toxic levels.