Effects of Surgical Wound Infiltration with Bupivacaine on Postoperative Analgesia in Cats Undergoing Bilateral Mastectomy

Abstract

The analgesic effect of wound infiltration with bupivacaine was evaluated in cats undergoing bilateral mastectomy. Twenty-one female cats with mammary gland tumors were anesthetized with propofol and oxygen-isoflurane anesthesia following premedication with atropine. In the trial group (Group I; n=11), 30 ml of saline containing 2 mg/kg of bupivacaine was infiltrated topically into the surgical wound right after removal of the mammary glands, whereas only saline solution was infiltrated in the control group (Group II; n=10). At the same time, carprofen (4 mg/kg) was also administered subcutaneously in both groups. Behavioral signs of pain were monitored during the recovery period after general anesthesia. In order to examine the behavioral changes associated with acute pain, a questionnaire was prepared and given to the owners to be completed 4 hr and then 10 hr after the operation. According to the owners’ anwers to the questionnaire, a pain score was specified using a “numerical rating scale” for each cat. Although some cats showed mild to moderate pain, the pain score recorded at 4 hr after the operation was significantly lower in Group I (P<0.001). No significant difference was found at 10 hr after the operation between the groups. The incidence of vocalization, aggression and convulsion within 2 hr after the operation was also lower in Group I. In conclusion, wound infiltration with bupivacaine before incisional closure provided reliable analgesia at least 4 hr after bilateral radical mastectomy in cats.

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

“…When used as part of a multimodal protocol, both intraoperative nociceptive indicators (e.g. heart rate, respiratory rate and blood pressure changes at the time of a nociceptive stimulus) and postoperative pain scores are lower in patients receiving local/regional anaesthesia along with systemically administered analgesics when compared to patients receiving systemically administered analgesics alone (Aguiar, Chebroux, Martinez-Taboada, & Leece, 2015;Benito et al, 2016;Carpenter, Wilson, & Evans, 2004;Mosing, Reich, & Moens, 2010;Myrna, Bentley, & Smith, 2010;Perez et al, 2013;Savvas et al, 2008;Yilmaz et al, 2014).…”

Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2)

“…Specific references for block technique and/or efficacy are provided where possible. 'Field block', also called incisional block or 'line' block (Vicente & Bergstrom, 2018;Lascelles, Rausch-Derra, Wofford, & Huebner, 2016;Yilmaz et al, 2014;Savvas et al 2008) Figure 1 and Box 3.…”

Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy

“…Mammary gland tumours account for 17% of all tumours in cats, and most of them are malignant and fast-growing [ 1 ]. Therefore, unilateral radical mastectomy is recommended for the treatment of mammary tumours [ 2 ].…”

“…The use of local anaesthetics added to general anaesthesia may help to control postoperative pain, constituting a multimodal analgesic strategy. Local anaesthetic can be injected into the operation site or infiltrated into the wound, inducing a rapid onset analgesic effect [ 1 ]. Furthermore, tumescent local anaesthesia using a large volume of diluted local anaesthetic for extensive subcutaneous tissue infiltration has been used for mastectomy in cats, providing effective analgesia during veterinary surgery and in the postoperative period [ 5 ].…”