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Equine veterinary journal2023; 55(5); 755-764; doi: 10.1111/evj.13915

Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares.

Abstract: Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species. Objective: To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.75% bupivacaine HCL (BHCl) for analgesia following laparoscopic ovariectomy in mares. Methods: Prospective cohort study. Methods: Fifteen healthy Quarter Horse mares (age 2-20 years) with normal bilateral ovarian palpation and appearance were enrolled. Horses were restrained in standing stocks and administered an α-2 agonist, butorphanol, and flunixin meglumine, followed by a variable rate infusion of sedation with α-2 agonists. Bilateral paralumbar fossa ovariectomies were performed. Treatment with either 30 ml 0.75% BHCl followed by 20 or 40 ml LB 13.3% (LB20 and LB40) volume expanded with saline to 80 ml total (n = 6/group) or 80 ml BHCl alone (n = 3, BCHL) was infused around incision sites and each mesovarium (LB or BHCl) prior to ovariectomy. Horses were monitored for 72 h by physical examination, algometry, and pain scoring (composite pain scale by Bussieres et al., Horse Grimace Scale). Abdominocentesis with peritoneal fluid analysis was performed at 72 h. Results: Analgesia achieved with all treatment protocols allowed completion of ovariectomy procedures. Pressure algometry scores were lower in BHCl-treated horses versus both LB groups overall. Pain scores were improved with LB-treated horses in a dose-dependent fashion (Horse Grimace Scale scores LB40 < LB20 < BHCL; composite pain scale scores LB40 < BHCL, LB20 < BHCL, BHCL, and LB20 did not differ). Peritoneal fluid total protein was lower in LB40 versus LB20 and BHCL horses. No complications from LB administration were appreciated. Conclusions: Small patient sample size, lack of follow-up past 72 h or histopathology. Conclusions: Analgesia duration was extended and pain scores improved postoperatively with LB versus BHCl in a dose-dependent fashion. Further clinical evaluation of extended-duration local anaesthetics in horses for improved postoperative pain management is warranted.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-01-09 PubMed ID: 36572902PubMed Central: PMC10291007DOI: 10.1111/evj.13915Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates the safety and effectiveness of liposomal bupivacaine (LB), a type of local anesthesia, in relieving pain following laparoscopic surgery in mares. The results show that using larger doses of LB can better control pain in a dose-dependent manner, and suggests that further studies are needed to explore the use of long-acting local anaesthetics in horses for improved post-surgery pain management.

Research Objective

The aim of this study was to evaluate and compare the effectiveness of two doses of 1.33% liposomal bupivacaine (LB) with 0.75% bupivacaine HCL (BHCl), a commonly used analgesic, in managing pain after a laparoscopic ovariectomy in horses.

Methods

  • The study involved fifteen healthy Quarter Horse mares, each aged between 2-20 years.
  • Each horse was first restrained and administered sedatives and pain relievers. An ovariectomy was performed after the medication was given.
  • The horses were then treated with either 0.75% BHCl followed by either 20 or 40 ml LB volume expanded with saline to 80 ml total or 80 ml BHCl alone. All were infused around incision sites prior to the ovariectomy.
  • The horses’ conditions were monitored for 72 hours through physical examinations, pressure algometry (a method to measure pain), pain scoring, and analysis of peritoneal fluid (fluid from the abdomen).

Results

  • The study showed that all treatment methods allowed the completion of the ovariectomy procedures.
  • Pressure algometry scores were lower in BHCl-treated horses versus the LB-treated horses.
  • The studies show that both doses of LB improved the horse’s comfort after surgery, displaying a dose-dependent improvement in pain scores.
  • The LB-treated horses had less total protein in their peritoneal fluid, which can indicate less inflammation.
  • There were no complications observed from the administration of LB.

Conclusions

The results indicate that LB can extend the duration of pain relief and improve post-surgery pain scores compared to BHCl in a dose-dependent way. However, the researchers mention limitations such as a small sample size and lack of follow-up past 72 hours. They conclude by recommending further clinical evaluation of extended-duration local anaesthetics in horses to improve postoperative pain management.

Cite This Article

APA
Pezzanite LM, Griffenhagen GM, Bass L, Okudaira M, Larson B, Hendrickson DA. (2023). Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares. Equine Vet J, 55(5), 755-764. https://doi.org/10.1111/evj.13915

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 5
Pages: 755-764

Researcher Affiliations

Pezzanite, Lynn M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Griffenhagen, Gregg M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Bass, Luke
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Okudaira, Mana
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Larson, Blaine
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Hendrickson, Dean A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Horses
  • Animals
  • Female
  • Prospective Studies
  • Ovariectomy / veterinary
  • Ovariectomy / methods
  • Bupivacaine
  • Anesthetics, Local
  • Laparoscopy / veterinary
  • Laparoscopy / methods
  • Pain / veterinary

Grant Funding

  • TL1 TR002533 / NCATS NIH HHS
  • T32 OD010437 / NIH HHS

Conflict of Interest Statement

Authors’ declarations of interest. The authors declare no competing interests related to this report.

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Citations

This article has been cited 1 times.
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