Evaluation of the usage of incisional liposomal bupivacaine as a local anaesthetic for dogs undergoing limb amputation

• Published in: Veterinary medicine and science 2023-07, Vol.9 (4), p.1547-1552
• Main Authors: Villatoro, Ashley S, Phelps, Holly A, Ganjei, Justin B
• Format: Article
• Language: English
• Subjects: Amputation; Amputation, Surgical - veterinary; Analgesia; Analgesics; Anesthetics, Local; Animals; Bupivacaine; control group (CG); Dog Diseases - surgery; DOGS; Drug dosages; Epidural; Hospitalization; Hospitals; Infections; liposomal bupivacaine group (LBG); liposomal bupivacaine suspension (LBS); Medical records; Narcotics; Original; Orthopedics; Pain; Pain, Postoperative - veterinary; Postoperative period; Retrospective Studies; Statistical analysis; Surgeons; Surgery; Veterinary medicine
• ISSN: 2053-1095; 2053-1095
• DOI: 10.1002/vms3.1159

Bupivacaine lioposomal suspension has recently emerged in the veterinary field for local analgesia. To describe the extra-label administration of bupivacaine liposomal suspension at the incision site of dogs undergoing limb amputation and characterize any complications. Nonblinded retrospective study. Client-owned dogs undergoing limb amputation from 2016 to 2020. Medical records of dogs undergoing limb amputation with concurrent use of long-acting liposomal bupivacaine suspension were reviewed for incisional complications, adverse effects, hospitalization length, and time to alimentation. Data were compared to a control group (CG) of dogs who underwent a limb amputation procedure without concurrent use of liposomal bupivacaine suspension. Forty-six dogs were included in the liposomal bupivacaine group (LBG) and 44 cases in the CG. The CG had 15 incidences of incisional complications (34%) compared to 6 within the LBG (13%). Four dogs required revisional surgery in the CG (9%) whereas none of the dogs required revisional surgery in the LBG. Time from surgery to discharge was statistically higher in the CG compared to the LBG (p = 0.025). First time to alimentation was statistically higher in the CG (p value = 0.0002). The total number of rechecks needed postoperatively revealed the CG having a statistically significant increase in recheck evaluations (p = 0.001). Extra-label administration of liposomal bupivacaine suspension was well-tolerated in dogs undergoing limb amputation. Liposomal bupivacaine usage did not increase incisional complication rates and its use allowed for a quicker time to discharge. Surgeons should consider inclusion of extra-label administration of liposomal bupivacaine in analgesic regimens for dogs undergoing limb amputation.