Bupivacaine liposomal injectable suspension does not provide improved pain control in dogs undergoing abdominal surgery

J Am Vet Med Assoc. 2023 Oct 6;262(2):1-9. doi: 10.2460/javma.23.05.0271. Print 2024 Feb 1.

Abstract

Objective: To evaluate the difference in postoperative pain scores of dogs undergoing abdominal surgery receiving surgical incision infiltration of saline or bupivacaine liposomal injectable suspension (BLIS).

Animals: 40 dogs undergoing exploratory laparotomy.

Methods: Dogs were prospectively enrolled and randomized to receive either BLIS or saline surgical incision infiltration. All dogs received 5.3 mg of BLIS/kg or an equal volume of saline infiltrated in the muscle/fascia, subcutaneous tissue, and intradermal layer during closure. All dogs received a standardized postoperative pain management protocol. Pain assessment was performed at select time points postoperatively by blinded observers with an electronic algometer, short version of the Glasgow Composite Measure Pain Scale (GCMPS), and indirect measures of pain, including systolic blood pressure, heart rate, and serum cortisol levels.

Results: At day 0, blood pressure was higher in the saline group (149.6 vs 125.8 mm Hg; P = .006). At day 3, GCMPS was lower in the BLIS group (BLIS = 1, saline = 2, P = .027), though both average GCMPS scores were low and only 10 dogs were available for day 3 assessments (6 BLIS and 4 saline). No other differences in algometer readings, GCMPS scores, other measured parameters, or need for rescue analgesia were present between BLIS and saline groups at any time point. There was no difference in postoperative incisional infection rate or complications.

Clinical relevance: Use of BLIS for exploratory laparotomy did not provide improved pain control over postoperative opioid administration alone. Patients that received BLIS had no increase in short-term complications.

Keywords: BLIS; Nocita; abdominal surgery; analgesia; liposomal bupivacaine.

Publication types

  • Randomized Controlled Trial, Veterinary

MeSH terms

  • Analgesia* / veterinary
  • Analgesics, Opioid
  • Anesthetics, Local / pharmacology
  • Anesthetics, Local / therapeutic use
  • Animals
  • Bupivacaine / pharmacology
  • Bupivacaine / therapeutic use
  • Dog Diseases* / surgery
  • Dogs
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / prevention & control
  • Pain, Postoperative* / veterinary
  • Surgical Wound* / veterinary

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Bupivacaine