Schrock Kelly, Gallaher Hayley M, Wilson Deborah V, Beaty Brenda
Department of Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA.
Independent Biostatistics Consultant, Denver, CO, USA.
J Feline Med Surg. 2025 Jan;27(1):1098612X241296421. doi: 10.1177/1098612X241296421.
The objective of this study was to evaluate the impact of liposomal bupivacaine (LB) as part of an opioid-sparing multimodal analgesic protocol on postoperative pain control in cats undergoing limb amputation surgery compared with traditional pain management protocols more heavily reliant on injectable opioid and non-opioid analgesics.
Medical records of 29 cats that underwent forelimb or hindlimb amputation were reviewed to evaluate postoperative systemic pain medications utilized, appetite and time to discharge as presumptive gauges of postoperative pain. Statistical analysis of the data included Wilcoxon's rank-sum test and Fisher's exact test.
Of the 29 cats, seven (24%) did not receive LB and 22 (76%) did. No statistically significant differences were found between the two groups in the outcome variables evaluated. The median time to eating was similar (6.0 h in the LB group vs 5.0 h in the non-LB group), the median time to discharge was shorter in the LB group (25.0 h vs 42.0 h in the non-LB group) and the median time to discontinuation of opioids in the LB treatment group was shorter than the non-LB group (18.0 h in LB group vs 22.0 h non-LB). A lower proportion of the LB group needed adjuvant systemic analgesics compared with the non-LB group (5% LB vs 29% non-LB).
The addition of liposomal bupivacaine to an analgesic protocol after limb amputation in cats is associated with reduced opioid dosing, earlier return to eating and earlier hospital discharge. The use of LB may minimize the negative side effects associated with systemic opioid administration and therefore decrease patient morbidity. Future studies are needed to definitively compare LB efficacy and safety for postoperative pain control and traditional systemic analgesic medications.
本研究的目的是评估脂质体布比卡因（LB）作为阿片类药物节省多模式镇痛方案的一部分，与更严重依赖注射用阿片类和非阿片类镇痛药的传统疼痛管理方案相比，对接受肢体截肢手术的猫术后疼痛控制的影响。
回顾了29只接受前肢或后肢截肢手术的猫的病历，以评估术后使用的全身镇痛药、食欲和出院时间，作为术后疼痛的推测指标。数据的统计分析包括Wilcoxon秩和检验和Fisher精确检验。
29只猫中，7只（24%）未接受LB，22只（76%）接受了LB。在评估的结果变量中，两组之间未发现统计学上的显著差异。进食的中位时间相似（LB组为6.0小时，非LB组为5.0小时），LB组的中位出院时间较短（LB组为25.0小时，非LB组为42.0小时），LB治疗组停用阿片类药物的中位时间比非LB组短（LB组为18.0小时，非LB组为22.0小时）。与非LB组相比，LB组需要辅助全身镇痛药的比例较低（LB组为5%，非LB组为29%）。
在猫肢体截肢术后的镇痛方案中添加脂质体布比卡因与减少阿片类药物剂量、更早恢复进食和更早出院有关。使用LB可能会使与全身阿片类药物给药相关的负面副作用最小化，从而降低患者的发病率。未来需要进行研究，以明确比较LB对术后疼痛控制的疗效和安全性与传统全身镇痛药。
