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Comparison of liposomal bupivacaine and 0.5% bupivacaine hydrochloride for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy

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  • 1 1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, Grafton, MA 01536.
  • | 2 2Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655.

Abstract

OBJECTIVE

To compare liposome-encapsulated bupivacaine (LEB) and (nonliposomal) 0.5% bupivacaine hydrochloride (0.5BH) for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy (TPLO).

ANIMALS

33 client-owned dogs.

PROCEDURES

In a randomized clinical trial, dogs undergoing TPLO received LEB (5.3 mg/kg [2.4 mg/lb]) or 0.5BH (1.5 mg/kg [0.68 mg/lb]) by periarticular soft tissue injection. All dogs received carprofen (2.2 mg/kg [1 mg/lb], SC, q 12 h) beginning at extubation. Signs of pain were assessed at extubation and predetermined times up to 48 hours later with the Colorado State University-Canine Acute Pain Scale and Glasgow Composite Pain Scale-Short Form. A pressure nociceptive threshold device was used at the affected stifle joint before surgery and at 5 postoperative time points. Methadone (0.1 mg/kg [0.05 mg/lb], IV) was administered if the Colorado State University pain scale score was ≥ 2 (scale, 0 to 4). Surgical variables; pain scores; pressure nociceptive thresholds; times to first administration of rescue analgesic, first walk, and first meal consumption; and total opioid administration were compared between treatment groups.

RESULTS

28 dogs completed the study. Dogs administered LEB were less likely to require rescue analgesia and received lower amounts of opioids than dogs administered 0.5BH. There were no significant intergroup differences in other measured variables.

CONCLUSIONS AND CLINICAL RELEVANCE

The LEB appeared to provide adequate analgesia after TPLO with lower requirements for opioid treatments, which may allow dogs to be discharged from the hospital earlier than with traditional pain management strategies.

Abstract

OBJECTIVE

To compare liposome-encapsulated bupivacaine (LEB) and (nonliposomal) 0.5% bupivacaine hydrochloride (0.5BH) for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy (TPLO).

ANIMALS

33 client-owned dogs.

PROCEDURES

In a randomized clinical trial, dogs undergoing TPLO received LEB (5.3 mg/kg [2.4 mg/lb]) or 0.5BH (1.5 mg/kg [0.68 mg/lb]) by periarticular soft tissue injection. All dogs received carprofen (2.2 mg/kg [1 mg/lb], SC, q 12 h) beginning at extubation. Signs of pain were assessed at extubation and predetermined times up to 48 hours later with the Colorado State University-Canine Acute Pain Scale and Glasgow Composite Pain Scale-Short Form. A pressure nociceptive threshold device was used at the affected stifle joint before surgery and at 5 postoperative time points. Methadone (0.1 mg/kg [0.05 mg/lb], IV) was administered if the Colorado State University pain scale score was ≥ 2 (scale, 0 to 4). Surgical variables; pain scores; pressure nociceptive thresholds; times to first administration of rescue analgesic, first walk, and first meal consumption; and total opioid administration were compared between treatment groups.

RESULTS

28 dogs completed the study. Dogs administered LEB were less likely to require rescue analgesia and received lower amounts of opioids than dogs administered 0.5BH. There were no significant intergroup differences in other measured variables.

CONCLUSIONS AND CLINICAL RELEVANCE

The LEB appeared to provide adequate analgesia after TPLO with lower requirements for opioid treatments, which may allow dogs to be discharged from the hospital earlier than with traditional pain management strategies.

Contributor Notes

Address correspondence to Dr. Reader (rebecca.reader@tufts.edu).