Intern Weatherford Equine Medical Center Weatherford, Texas
The Use of Liposomal Bupivacaine as an Incisional Analgesic and Its Effect on Incisional Healing in Horses. Steiner M1, Patton M2, da Cunha A3, Fugler L1, Mitchell C1, Leise BS1. 1Louisiana State University, School of Veterinary Medicine, Baton Rouge, LA; 2Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA; 3Midwestern University, Glendale, AZ.
Application of local anesthetics can improve pain relief postoperatively; however, local anesthetics have been reported to result in impaired wound healing. The objectives of this study were to determine if administration of a local injection of liposomal bupivacaine (NOCITA®) would provide prolonged anesthesia to a surgical incision without affecting wound healing or altering the inflammatory response at the incision site. We hypothesized that administration of NOCITA® would provide local analgesia over a period of days, would not delay healing, and would have a minimal effect on the inflammatory response at the incision. Incisions were made on both sides of the paralumbar fossa in six horses. Incisions were then randomly assigned to one of two treatment groups. One side received a subcutaneous injection of NOCITA®, while the other side received an equivalent volume of saline as a control. Incisional sensation was assessed using Von Frye filaments. Incisional healing was subjectively evaluated daily and margin biopsies were obtained on days 0, 3, 7, and 14 for histological evaluation. Incisions treated with NOCITA® had significantly decreased sensation (P < 0.05) when compared with saline for 24 hours post-surgery. No differences were noted in incisional healing between groups. The number of neutrophils/macrophages at the incisional margin were not significantly different between groups. Limitations of the study included small sample size. Results from this study support the use of NOCITA® at the incisional margin as sensitization was decreased in treated horses and did not appear to alter wound healing.