Evaluation of the usage of incisional liposomal bupivacaine as a local anaesthetic for dogs undergoing limb amputation.

Background: Bupivacaine lioposomal suspension has recently emerged in the veterinary field for local analgesia.

Objective: To describe the extra-label administration of bupivacaine liposomal suspension at the incision site of dogs undergoing limb amputation and characterize any complications.

Study Design: Nonblinded retrospective study.

Animals: Client-owned dogs undergoing limb amputation from 2016 to 2020.

Methods: Medical records of dogs undergoing limb amputation with concurrent use of long-acting liposomal bupivacaine suspension were reviewed for incisional complications, adverse effects, hospitalization length, and time to alimentation. Data were compared to a control group (CG) of dogs who underwent a limb amputation procedure without concurrent use of liposomal bupivacaine suspension.

Results: Forty-six dogs were included in the liposomal bupivacaine group (LBG) and 44 cases in the CG. The CG had 15 incidences of incisional complications (34%) compared to 6 within the LBG (13%). Four dogs required revisional surgery in the CG (9%) whereas none of the dogs required revisional surgery in the LBG. Time from surgery to discharge was statistically higher in the CG compared to the LBG (p = 0.025). First time to alimentation was statistically higher in the CG (p value = 0.0002). The total number of rechecks needed postoperatively revealed the CG having a statistically significant increase in recheck evaluations (p = 0.001).

Conclusions: Extra-label administration of liposomal bupivacaine suspension was well-tolerated in dogs undergoing limb amputation. Liposomal bupivacaine usage did not increase incisional complication rates and its use allowed for a quicker time to discharge.

Clinical Significance: Surgeons should consider inclusion of extra-label administration of liposomal bupivacaine in analgesic regimens for dogs undergoing limb amputation.