New nerve blocking pain control following limb amputation

Irish setter and pug restingStudy Title: Bupivacaine liposome injectable suspension as analgesia following limb amputation in dogs
Current Status: Open and enrolling
Investigators: Wanda Gordon-Evans, DVM, PhD, DACVS, DACVSMR, Alonso Guedes, DVM, MS, PhD, DACVAA, Alena Strelchik, DVM
Contacts: Dr. Alena Strelchik, astrelch@umn.edu, 612-624-5308

Purpose

Standard methods of pain control post-amputation surgery include opioid drugs plus anti-inflammatory drugs which can have adverse effects. For example, injectable opioids can be associated with nausea, vomiting and dysphoria. Local anesthetics, such as bupivacaine liposome injectable suspension (BLIS), are very effective at controlling pain, with no reported adverse effects. BLIS has been shown to provide pain control for 72 hours following knee surgery in dogs but has not been developed for use in other common surgical procedures, such as limb amputation. This blinded study compares standard of care analgesia (pain control) to bupivacaine liposome injectable suspension.

Eligible dogs

Dogs of any age, breed, weight and sex that require forelimb or hindlimb amputation can be included in the study. Dogs receiving NSAIDs or steroids will be appropriately transitioned to carprofen after a 3-day washout period prior to surgery. 

Dogs that are fractious, of have clinically significant comorbidities (i.e. polytrauma, neurologic, hepatic, renal, uncontrolled endocrine disorder), a history of gastrointestinal problems associated with NSAID use, or those requiring major reconstructive flaps will be excluded.

Study summary

Dogs will be randomly assigned to Group 1 or Group 2. Group 1 will receive the new BLIS therapy during surgery and saline for 24 hours post-surgery. Group 2 will serve as the control and will receive standard of care local anesthetic during surgery, and an opioid for 24 hours post-surgery. While in the hospital, pain scores will be taken regularly and if a dog is experiencing unacceptable pain, the dog will be provided rescue analgesia. All dogs will receive oral carprofen twice/day for 5 days at discharge. Owners will assess pain in their dog at home and record it for the study. The final study visit is a recheck at 14 days postoperatively. 

Costs of the study

The initial exam fee and work-up, and surgery and anesthesia are the responsibility of the owner. Once enrolled, the study will pay for the BLIS treatment and 12 hours of ICU care post-surgery. 

For more information, contact Dr. Strelchik (above).