Analgesic effect of bupivacaine eluting porcine small intestinal submucosa (SIS) in ferrets undergoing acute abdominal hernia defect surgery.
BACKGROUND
Porcine small intestinal submucosa (SIS) is used as a biological implant for abdominal wall hernia repair to facilitate wound healing and augment local tissue strength. This prospective, randomized, blinded study evaluated local pain control provided by bupivacaine adsorbed to SIS for repair of acutely created abdominal wall full thickness muscle/fascial defects in ferrets.


METHODS
Eighteen healthy ferrets were randomly and equally assigned to three groups: (1) SIS with bupivacaine subjected to surgery, (2) SIS with no bupivacaine subjected to surgery, and (3) anesthesia only control group. Ferrets in groups 1 and 2 were anesthetized with butorphanol and sevoflurane for the surgery. Control ferrets were anesthetized in the same fashion for the same duration without surgery. Behavior and pain were evaluated in all ferrets by behavioral observation, algometer, and palpometer measurements, and heart and respiratory rates each obtained before surgery and at various intervals for 96 h after surgery. When pain reached a predetermined threshold, buprenorphine was used as a rescue analgesic. The serum and combined tissue concentrations of bupivacaine were analyzed.


RESULTS
Overall, the palpometer testing was better tolerated in the bupivacaine treated SIS group than by the untreated SIS group (P = 0.04). There was an observed physiologically significant difference in algometer and other palpometer readings as well as heart and respiratory rates. All ferrets in the untreated SIS group were rescued while 33% of the SIS-bupivacaine groups were rescued (P < 0.01). Peak serum concentrations of bupivacaine were in the range of 0.7 μg/mL with tissue level below detection levels and no clinical signs of toxicity were observed.


CONCLUSIONS
Bupivacaine adsorbed to SIS provided some degree of pain relief over 2-4 days with no clinical adverse effects observed in the ferrets.
Johnson
Brenda M
BM
Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA.
Ko
Jeff C
JC
Hall
Paul J
PJ
Saunders
Alan T
AT
Lantz
Gary C
GC
D000208:Acute Disease; D000700:Analgesics / Q000627:therapeutic use*; D000818:Animals; D002045:Bupivacaine / Q000627:therapeutic use*; D005289:Ferrets; D046449:Hernia, Abdominal / Q000601:surgery*; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D023421:Models, Animal; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D011897:Random Allocation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013552:Swine; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D000700:Analgesics; D002045:Bupivacaine