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Use of lidocaine-bupivacaine–infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia following eye enucleation in dogs

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  • 1 Department of Ophthalmology, VCA Animal Hospital, Aurora, IL 60506.
  • | 2 Department of Ophthalmology, VCA Animal Hospital, Aurora, IL 60506.
  • | 3 Department of Ophthalmology, VCA Animal Hospital, Aurora, IL 60506.
  • | 4 Department of Ophthalmology, VCA Animal Hospital, Aurora, IL 60506.
  • | 5 Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61803.

Abstract

Objective—To compare use of lidocaine-bupivacaine–infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia in dogs following eye enucleation.

Design—Randomized case-control study.

Animals—19 dogs that underwent eye enucleation.

Procedures—19 client-owned dogs admitted to a referral hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to receive an orbital absorbable gelatin hemostatic sponge infused with lidocaine and bupivacaine after globe removal (n = 8) or retrobulbar injection of lidocaine and bupivacaine before globe removal (11). Baseline pain scores were recorded on the basis of an ordinal pain scale. Anesthetic premedication consisted of hydromorphone, midazolam, and glycopyrrolate. Propofol was used for anesthetic induction and isoflurane for maintenance. A transpalpebral eye enucleation was performed by a board-certified ophthalmologist. Pain scores and heart rate were again recorded 15 and 30 minutes and 1, 2, 4, 6, 8, and 24 hours after extubation by trained observers masked to treatment groups. Dogs were given hydromorphone as rescue analgesia if the total pain score was ≥ 9 of 18 or any categorical pain score was ≥ 3 (on a scale from 0 to 3 or 0 to 4).

Results—There were significant differences over time for comfort level, response to touch, behavior, heart rate, and total pain score; however, there was no difference between treatment groups. One dog in the absorbable gelatin hemostatic sponge group required rescue hydromorphone 4 hours after surgery.

Conclusions and Clinical Relevance—The absorbable gelatin hemostatic sponge proved to be as effective in providing local analgesia for eye enucleation in dogs as the retrobulbar injections.

Abstract

Objective—To compare use of lidocaine-bupivacaine–infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia in dogs following eye enucleation.

Design—Randomized case-control study.

Animals—19 dogs that underwent eye enucleation.

Procedures—19 client-owned dogs admitted to a referral hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to receive an orbital absorbable gelatin hemostatic sponge infused with lidocaine and bupivacaine after globe removal (n = 8) or retrobulbar injection of lidocaine and bupivacaine before globe removal (11). Baseline pain scores were recorded on the basis of an ordinal pain scale. Anesthetic premedication consisted of hydromorphone, midazolam, and glycopyrrolate. Propofol was used for anesthetic induction and isoflurane for maintenance. A transpalpebral eye enucleation was performed by a board-certified ophthalmologist. Pain scores and heart rate were again recorded 15 and 30 minutes and 1, 2, 4, 6, 8, and 24 hours after extubation by trained observers masked to treatment groups. Dogs were given hydromorphone as rescue analgesia if the total pain score was ≥ 9 of 18 or any categorical pain score was ≥ 3 (on a scale from 0 to 3 or 0 to 4).

Results—There were significant differences over time for comfort level, response to touch, behavior, heart rate, and total pain score; however, there was no difference between treatment groups. One dog in the absorbable gelatin hemostatic sponge group required rescue hydromorphone 4 hours after surgery.

Conclusions and Clinical Relevance—The absorbable gelatin hemostatic sponge proved to be as effective in providing local analgesia for eye enucleation in dogs as the retrobulbar injections.

Contributor Notes

Dr. Ploog's present address is Omaha's Henry Doorly Zoo and Aquarium, 3701 S 10th St, Omaha, NE 61807. Dr. Swinger's present address is Animal Eye Guys of South Florida, Ft. Lauderdale, FL 33303. Dr. Spade's present address is VERGI, 8921 Katy Freeway, Houston, TX 77024. Dr. Quandt's present address is Michigan Veterinary Specialists, 29080 Inkster Rd, Southfield, MI 48034.

Presented in abstract form at the 43rd Annual American College of Veterinary Ophthalmologists Conference, Portland, Ore, October 2012.

Address correspondence to Dr. Ploog (Christina.ploog@omahazoo.com).