Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares.
Authors: Pezzanite Lynn M, Griffenhagen Gregg M, Bass Luke, Okudaira Mana, Larson Blaine, Hendrickson Dean A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Liposomal Bupivacaine for Equine Ovariectomy Following laparoscopic ovariectomy in mares, liposomal bupivacaine (LB) infiltrated around surgical sites and the mesovarium demonstrated superior postoperative pain control compared with conventional bupivacaine hydrochloride, with benefits appearing in a dose-dependent manner. Fifteen Quarter Horse mares received either 40 ml or 20 ml of 1.33% liposomal bupivacaine plus 30 ml conventional bupivacaine, or conventional bupivacaine alone (control); pain assessment using Horse Grimace Scale and composite pain scoring over 72 hours revealed the highest liposomal dose (LB40) produced the lowest pain scores, whilst peritoneal fluid analysis at 72 hours showed reduced total protein in the LB40 group, indicating potentially less inflammatory response. Notably, pressure algometry scores were paradoxically lower in control horses, suggesting that mechanical pain sensitivity may not fully reflect the subjective pain experience measured by facial expression and behavioural assessment—findings that warrant consideration when interpreting multimodal pain assessments. No adverse effects were documented from intra-peritoneal liposomal bupivacaine administration, though the study's small sample size and lack of assessment beyond 72 hours limit broader application of these findings. For equine practitioners, this research supports exploration of extended-duration local anaesthetics in surgical protocols, potentially reducing reliance on systemic analgesics during the critical early postoperative period.
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Practical Takeaways
- •Liposomal bupivacaine infiltration at surgical sites during laparoscopic ovariectomy can extend postoperative analgesia duration and reduce pain scores in mares compared to standard bupivacaine, with 40 ml doses showing superior pain control
- •This extended-duration local anesthetic approach may reduce reliance on systemic analgesics in the immediate postoperative period, improving mare welfare and potentially reducing medication costs
- •Further long-term follow-up studies beyond 72 hours are needed before changing clinical practice, but current evidence supports investigation of liposomal local anesthetics for routine laparoscopic ovariectomy procedures
Key Findings
- •Liposomal bupivacaine (LB) provided dose-dependent analgesia superior to standard bupivacaine HCl (BHCl) when infiltrated at surgical sites and mesovarium in mares undergoing laparoscopic ovariectomy
- •Horse Grimace Scale pain scores showed LB40 < LB20 < BHCl, demonstrating extended-duration analgesia with higher LB doses over 72 hours
- •Pressure algometry paradoxically showed lower scores in BHCl-treated horses versus both LB groups, suggesting multimodal pain assessment is necessary
- •No adverse effects or complications from intra-peritoneal liposomal bupivacaine administration were observed during the 72-hour monitoring period