Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs

Abstract

OBJECTIVE To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS 20 client-owned dogs undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.

Use of bupivacaine‐infused absorbable gelatin haemostatic sponge following eye enucleation in a corn snake

“…8,9 Intraorbital gelfoam infused with ropivacaine 1% in addition to systemic analgesia following enucleation provided better immediate post-operative analgesia when compared to patients receiving systemic analgesia alone. 8 However, no conclusions could be made when comparing gelfoam infused with lidocainebupivacaine placed in the orbit in addition with systemic analgesia versus the retrobulbar nerve block due to the type II statistical error reported. 9 The mechanism of action for AGHSs is not fully understood.…”

“…In dogs, absorbable gelatin sponge material (gelfoam) infused with a local anaesthetic was investigated as an alternative to retrobulbar and peribulbar nerve blocks 8,9 . Intraorbital gelfoam infused with ropivacaine 1% in addition to systemic analgesia following enucleation provided better immediate post‐operative analgesia when compared to patients receiving systemic analgesia alone 8 .…”

“…In dogs, absorbable gelatin sponge material (gelfoam) infused with a local anaesthetic was investigated as an alternative to retrobulbar and peribulbar nerve blocks 8,9 . Intraorbital gelfoam infused with ropivacaine 1% in addition to systemic analgesia following enucleation provided better immediate post‐operative analgesia when compared to patients receiving systemic analgesia alone 8 . However, no conclusions could be made when comparing gelfoam infused with lidocaine‐bupivacaine placed in the orbit in addition with systemic analgesia versus the retrobulbar nerve block due to the type II statistical error reported 9 .…”

“…Intraorbital insertion of ropivacaine 1% soaked absorbable gelatin haemostatic sponges (AGHS) in combination with systemic analgesia in dogs following enucleation provides better immediate post‐operative analgesia when compared to patients receiving systemic analgesia alone 8 . In another canine enucleation study, the use of gelfoam infused with lidocaine‐bupivacaine placed in the orbit, in addition to systemic analgesia, provided comparable analgesic effects to a retrobulbar nerve block.…”