This study compared
bupivacaine (BUP),
bupivacaine-
lidocaine-
epinephrine (BLE),
dexamethasone (DEX), and
meloxicam (MEL) targeted at specific, potentially painful sites for reducing
acute postoperative pain in cats undergoing elective ovariohysterectomy. One hundred fifty-one cats were included in a prospective, randomized, double-blinded clinical trial.
Anesthesia consisted of a standardized protocol including
buprenorphine,
ketamine,
dexmedetomidine, and
isoflurane. A ventral midline ovariohysterectomy was performed, and cats were administered targeted
injections of 0.5%
bupivacaine (2 mg/kg); a combined 0.25%
bupivacaine (1 mg/kg), 1%
lidocaine (2 mg/kg), and 1:100,000
epinephrine (0.005 mg/kg);
dexamethasone (0.125 mg/kg); or
meloxicam (0.2 mg/kg) intraoperatively at the ovarian suspensory ligaments, uterine body, and incisional subcutaneous tissues. A 0-10 Numeric
Pain Rating Scale (NRS) was used to assess cats postoperatively, 1 hour and 3 hours after
anesthesia recovery prior to a same day discharge.
Pain scores among evaluators were in good agreement with an overall Intraclass Correlation Coefficient (ICC) of 0.7897 (95% Confidence Interval 0.795-0.8313). In all groups, overall
pain scores 1-hour post
anesthesia recovery were significantly higher than scores 3 hours post
anesthesia recovery (P < .0001). Averaged
pain scores compared among treatment groups did not differ at 1 hour post recovery. At 3-hours post
anesthesia recovery, MEL group cats had significantly lower
pain scores than the BLE group (P = .018). Study results indicate that early
postoperative pain scores were similar for cats receiving local infiltrations of BUP, BLE, DEX, and MEL as part of a multimodal
pain therapy for routine ovariohysterectomies. MEL showed somewhat better results 3 hours post
anesthesia recovery, gaining significance over the BLE group.