Hollenbeck Danielle L, Knue Joseph D, Simon Bradley T, Jeffery Nicholas D, Thieman Mankin Kelley M, Dickerson Vanna M
J Am Vet Med Assoc. 2025 Jan 22;263(4):521-527. doi: 10.2460/javma.24.09.0589. Print 2025 Apr 1.
To evaluate the impact of peri-incisional liposomal bupivacaine (LB) on postoperative pain scores, opioid use after soft tissue surgeries, and incidence of incision site complications in dogs.
Client-owned dogs (n = 83) were enrolled in a randomized, blinded, placebo-controlled clinical study for dogs undergoing a variety of soft tissue surgical procedures between March 31, 2021, and August 18, 2022. After incision closure, an injection of a placebo (0.9% NaCl) or LB was administered into the peri-incisional subcutaneous tissues. Pain was assessed via the Glasgow Composite Measure Pain Scale (CMPS-SF) preoperatively, at extubation, and at 2, 4, 8, 12, 24, 30, 36, 48, 54, 60, and 72 hours postoperatively or until time of discharge. The need for rescue analgesia was assessed based on CMPS-SF guidelines. The effect of LB on pain scores was analyzed with mixed-model linear regression, and the χ2 test was used to examine effects on incision complications and need for rescue analgesia.
83 dogs were enrolled. There was no significant difference in CMPS-SF scores between LB and placebo groups at any time period. Rescue analgesia was administered to 21 dogs in each group and was not significantly different. There was no significant difference in incision site complications. The incidence of surgical site infections was 6.0% for all procedures.
Peri-incisional LB did not significantly decrease the use of rescue analgesia for postoperative soft tissue surgeries in a clinical setting with the use of multimodal analgesia. This is consistent with findings in human literature.
Clinicians should not rely on LB used in the peri-incisional subcutaneous tissue to improve analgesia in patients undergoing soft tissue surgery.
评估切口周围注射脂质体布比卡因（LB）对犬软组织手术后疼痛评分、阿片类药物使用情况以及切口部位并发症发生率的影响。
2021年3月31日至2022年8月18日期间，将客户拥有的犬（n = 83）纳入一项针对接受各种软组织手术的犬的随机、双盲、安慰剂对照临床研究。切口缝合后，在切口周围皮下组织注射安慰剂（0.9%氯化钠）或LB。术前、拔管时以及术后2、4、8、12、24、30、36、48、54、60和72小时或直至出院时，通过格拉斯哥综合疼痛测量量表（CMPS-SF）评估疼痛情况。根据CMPS-SF指南评估急救镇痛的需求。采用混合模型线性回归分析LB对疼痛评分的影响，并使用χ2检验检查对切口并发症和急救镇痛需求的影响。
共纳入83只犬。LB组和安慰剂组在任何时间段的CMPS-SF评分均无显著差异。每组有21只犬接受了急救镇痛，且无显著差异。切口部位并发症无显著差异。所有手术的手术部位感染发生率为6.0%。
在使用多模式镇痛的临床环境中，切口周围注射LB并未显著减少术后软组织手术的急救镇痛药物使用。这与人类文献中的研究结果一致。
临床医生不应依赖在切口周围皮下组织使用LB来改善软组织手术患者的镇痛效果。
