Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery

Abstract

ObjectiveTo compare postoperative analgesic use and postoperative complications between dogs that received liposomal bupivacaine (LB) during surgical gastrointestinal foreign body (GIFB) removal and those that did not.Study designRetrospective study.AnimalsTwo hundred five dogs.MethodsMedical records for all dogs with GIFB removal at the Purdue University Veterinary Hospital between May 2017 and August 2021 were searched. Incomplete records and dogs with less than 2 weeks’ veterinary follow up were excluded. Data collected included: patient information, time until surgery, intraoperative findings, surgical data (including perforation at time of surgery, linear vs. solid, enterotomy vs. enterectomy), use of LB (including time and manner of administration), time to extubation after surgery, in‐hospital postoperative analgesic use and duration, and postoperative complications. Fentanyl was noted as used/not used, quantified as mean hourly rate over 12 h intervals. All analyses were performed using commercial statistical software with p < .05 as the significance level.ResultsDogs that received LB were heavier (n = 65, median 28.5 kg) than those that did not (n = 140, median 24.4 kg) (p = .005). Postoperative fentanyl use (p < .05 between 13 and 72 h) and hourly rates (p < .05 between 13 and 48 h) were less, and postoperative time in the intensive care unit (ICU) (p < .001) and hospital were shorter (p < .001) in dogs receiving LB. Postoperative wound complications were seen in 7/65 dogs (10.8%, 95% CI = 4.4–21.0%) with LB and 4/140 (2.9%, 95% CI = 0.8–7.2%) without LB (p = .039).ConclusionUse of LB was associated with reduced postoperative analgesic use, and shortened ICU and hospital stay but also with wound complications.Clinical significanceCaution should be used when using LB in (clean) contaminated surgeries.

Use of liposomal bupivacaine in dogs and cats undergoing gastrointestinal surgery is not associated with a higher rate of surgical site infections or multidrug-resistant infections

“…6,7 The off-label use of incisional infiltration of Nocita at the time of incisional closure for gastrointestinal surgery, however, is common at the authors' institutions. In a recent study, 8 the incisional complication rate (infection, seroma, and dehiscence) was 10.8% in 65 dogs that received Nocita during foreign body surgery, higher than reported for dogs that did not receive Nocita (n = 140) during foreign body surgery. The SSI rate was also higher in dogs that received Nocita, as 1.5% of the 65 dogs developed an SSI, compared to 0.7% of 140 dogs that did not receive Nocita.…”

“…The SSI rate was also higher in dogs that received Nocita, as 1.5% of the 65 dogs developed an SSI, compared to 0.7% of 140 dogs that did not receive Nocita. 8 This study did not report the bacterium isolated, nor did it indicate whether dogs diagnosed with SSI had surgeries performed under clean-contaminated or dirty conditions. Another study 9 found that the incidence of wound complications after infiltration of liposomal bupivacaine in dogs did not vary significantly between clean, clean-contaminated, and dirty surgeries but that the overall wound complication rate was 19.7%, with contaminated and clean-contaminated surgeries having high complication rates of 30.8% and 23.1%, respectively.…”