Liposomal bupivacaine provides longer duration analgesia than bupivacaine hydrochloride in an adjustable sole-pressure model of equine lameness

Abstract

OBJECTIVE To compare the efficacy and duration of action for perineural analgesia with liposomal bupivacaine (LB) versus bupivacaine hydrochloride (BHCl) in a sole-pressure induced model of forelimb lameness in horses. ANIMALS 6 healthy adult research horses. PROCEDURES In 1 randomly assigned forelimb, grade 3/5 lameness was induced by use of a sole-pressure lameness model. Objective lameness (vector sum [VS]) was determined with an inertial sensor system at 0, 1, 6, and 24 hours after lameness induction to evaluate the model. Mechanical nociceptive thresholds (MNTs) and objective lameness (VS and force platform kinetics) were recorded prior to and at 1, 6, 24, 48, and 72 hours after perineural anesthesia of the palmar nerves at the level of the proximal sesamoid bones with LB or BHCl in random order, with a 1-week washout period between crossover treatments. Data analysis was performed with mixed-model ANOVA. RESULTS When evaluating the lameness model, there was a decrease in lameness at 24 hours in at least 1 limb of each horse (7/12 limbs); thus, screw length was increased by 1 to 2 mm at each 24-hour interval to maintain lameness. Compared with results at baseline, horses treated with BHCl had significant improvements in median MNT and VS identified at only 1 hour after injection, whereas treatment with LB yielded significantly improved median MNT, VS score, and peak vertical force for up to 24 hours. DISCUSSION In this experimental model of forelimb lameness, LB provided longer analgesia when compared with BHCl and should be further investigated for treatment of pain in horses.

Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares

“…The assignment to groups was accomplished by generating a random sequence of 12 letters (A, B, and C) corresponding to the three groups. These were then sealed into consecutively numbered envelopes (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), and each case that was recruited was assigned the next numbered envelope. The three groups were (A) Group LB20-0.75% BHCl (30 ml) followed by LB 20 ml (266 mg), volume expanded to 80 ml with sterile saline (1:4 volume expansion), (B) Group LB40-0.75% BHCl (30 ml) followed by LB 40 ml (532 mg) volume expanded to 80 ml with sterile saline (1:2 volume expansion) or (C) Group BHCL-0.75% BHCl alone (70 ml).…”

“…9,10 Reports in horses to date are limited to intra-articular administration and perineural application in distal limbs with variable results, presumably due to differences in dose administered. [11][12][13][14] The use of LB for tissue infiltration has been gaining popularity in humans, 4,[15][16][17][18][19][20] and is now commonly used in many settings, including knee, hip, and shoulder surgery, abdominal procedures, and plastic surgery. The advantages of a long-lasting local anaesthetic include decreased opioid consumption and improved analgesia in people, 4,[15][16][17][18][19][20] benefits that can easily translate into improved outcomes for horses.…”

“…A number of studies have been performed in dogs, rabbits, and pigs to determine the safety and efficacy of the formulation, 6–8 and studies performed in the dog have shown good analgesia provided by LB following stifle surgery and limb amputations 9,10 . Reports in horses to date are limited to intra‐articular administration and perineural application in distal limbs with variable results, presumably due to differences in dose administered 11–14 . The use of LB for tissue infiltration has been gaining popularity in humans, 4,15–20 and is now commonly used in many settings, including knee, hip, and shoulder surgery, abdominal procedures, and plastic surgery.…”

Effects of subconjunctival ropivacaine, liposomal bupivacaine, and mepivacaine on corneal sensitivity in healthy horses

“…11,12 Liposomal bupivacaine has been evaluated in numerous studies for perineural and articular analgesia in horses. [13][14][15][16][17] Ropivacaine is a sodium channel blocker that has a prolonged duration of action due to its mild vasoconstrictive activity. 18,19 Ropivacaine has been evaluated in numerous studies for perineural, articular and epidural analgesia in horses.…”

“…The vesicles break down slowly after injection and are responsible for the slow release of bupivacaine 11,12 . Liposomal bupivacaine has been evaluated in numerous studies for perineural and articular analgesia in horses 13–17 . Ropivacaine is a sodium channel blocker that has a prolonged duration of action due to its mild vasoconstrictive activity 18,19 .…”