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Use of a continuous, local infusion of bupivacaine for postoperative analgesia in dogs undergoing total ear canal ablation

MaryAnn G. Radlinsky DVM, MS, DACVS1,2, Diane E. Mason DVM, PhD, DACVA3, James K. Roush DVM, MS, DACVS4, and Rosalind Pineda DVM5
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  • 1 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 2 Present address is the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 4 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 5 Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.

Abstract

Objective—To determine whether addition of a continuous, local infusion of bupivacaine would improve postoperative analgesia in dogs undergoing total ear canal ablation.

Design—Randomized controlled trial.

Animals—16 dogs undergoing total ear canal ablation (12 unilaterally and 4 bilaterally with > 1 month between procedures).

Procedure—Dogs were randomly allocated to receive morphine (0.25 mg/kg [0.11 mg/lb]) at the end of the procedure (10 procedures) or morphine and a continuous, local infusion of bupivacaine (0.13 to 0.21 mg/kg/h [0.06 to 0.1 mg/lb/h]; 10 procedures). Dogs were observed for 48 hours after surgery. Additional doses of morphine were administered up to every 4 hours in dogs with signs of severe pain.

Results—Temperament, sedation, analgesia, and cumulative pain scores were not significantly different between groups any time after surgery. Recovery score was significantly higher for dogs that received bupivacaine than for control dogs 2 hours after extubation but not at any other time. Serum cortisol concentration was not significantly different between groups at any time but, in both groups, was significantly increased at the time of extubation, compared with all other observation times. Total number of additional doses of morphine administered was not significantly different between groups. Bupivacaine was not detected in the plasma of any of the dogs that received the local bupivacaine infusion.

Conclusions and Clinical Relevance—Results suggest that addition of a continuous, local infusion of bupivacaine did not significantly increase the degree of postoperative analgesia in dogs that underwent total ear canal ablation and were given morphine at the end of surgery. (J Am Vet Med Assoc 2005;227:414–419)

Abstract

Objective—To determine whether addition of a continuous, local infusion of bupivacaine would improve postoperative analgesia in dogs undergoing total ear canal ablation.

Design—Randomized controlled trial.

Animals—16 dogs undergoing total ear canal ablation (12 unilaterally and 4 bilaterally with > 1 month between procedures).

Procedure—Dogs were randomly allocated to receive morphine (0.25 mg/kg [0.11 mg/lb]) at the end of the procedure (10 procedures) or morphine and a continuous, local infusion of bupivacaine (0.13 to 0.21 mg/kg/h [0.06 to 0.1 mg/lb/h]; 10 procedures). Dogs were observed for 48 hours after surgery. Additional doses of morphine were administered up to every 4 hours in dogs with signs of severe pain.

Results—Temperament, sedation, analgesia, and cumulative pain scores were not significantly different between groups any time after surgery. Recovery score was significantly higher for dogs that received bupivacaine than for control dogs 2 hours after extubation but not at any other time. Serum cortisol concentration was not significantly different between groups at any time but, in both groups, was significantly increased at the time of extubation, compared with all other observation times. Total number of additional doses of morphine administered was not significantly different between groups. Bupivacaine was not detected in the plasma of any of the dogs that received the local bupivacaine infusion.

Conclusions and Clinical Relevance—Results suggest that addition of a continuous, local infusion of bupivacaine did not significantly increase the degree of postoperative analgesia in dogs that underwent total ear canal ablation and were given morphine at the end of surgery. (J Am Vet Med Assoc 2005;227:414–419)