title: Antinociceptive activity of pre- versus post-operative intra-articular bupivacaine in goats undergoing stifle arthrotomy.
abstract: OBJECTIVE
  To evaluate the peri-operative analgesic efficacy of intra-articular bupivacaine administered before or after stifle arthrotomy.
  
  
  METHODS
  Prospective, randomized, blind, placebo-controlled experimental trial.
  
  
  METHODS
  Thirty-nine healthy goats.
  
  
  METHODS
  The goats were allocated randomly to one of three intra-articular treatment groups: group PRE (bupivacaine before and saline after surgery), group POST (saline before and bupivacaine after surgery) and group CON (saline before and after surgery). Anaesthesia was maintained with a constant end-tidal sevoflurane of 2.5%. Intra-operatively heart rate (HR), respiratory rate and mean arterial blood pressure (MAP) after critical surgical events (CSE) were recorded and compared with pre-incision values. Propofol requirements to maintain surgical anaesthesia were recorded. Flunixin was administered for 5 days. Post-operative pain assessment at 20 minutes, 2 hours, 4 hours after recovery and on day 2 and 3 included a multidimensional pain score (MPS), a lameness score and mechanical nociceptive threshold (MNT) testing. Rescue analgesia consisted of systemic opioids. Data were analysed using Kruskal-Wallis, Mann-Whitney, Friedman or chi-square tests as appropriate.
  
  
  RESULTS
  Intra-operatively, group PRE had lower HR and MAP at several CSEs than groups POST/CON and required less propofol [0 mg kg(-1) (0-0 mg kg(-1))] than group POST/CON [0.3 mg kg(-1) (0-0.6 mg kg(-1))]. Post-operatively, group POST had significantly higher peri-articular MNTs than groups PRE and CON up to 4 hours after recovery. No treatment effect was detected for MPS, lameness scores and rescue analgesic consumption at any time point.
  
  
  CONCLUSIONS
  Pre-operative intra-articular bupivacaine provided notable intra-operative analgesia in goats undergoing stifle arthrotomy but did not reduce post-operative pain. Post-operative intra-articular bupivacaine provided a short lasting reduction of peri-articular hyperalgesia without affecting the requirements for systemic analgesia. Multimodal perioperative pain therapy is recommended to provide adequate analgesia for stifle arthrotomy in goats.
authors.affiliation: Anaesthesia Section, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Switzerland Allevia AG, The Bone CRO, Bern, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Krohm
authors.forename: Olivier
authors.initials: O
authors.lastname: Levionnois
authors.forename: Murielle
authors.initials: M
authors.lastname: Ganster
authors.forename: Luca
authors.initials: L
authors.lastname: Zilberstein
authors.forename: Claudia
authors.initials: C
authors.lastname: Spadavecchia
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006041:Goats / Q000601:surgery*; D007270:Injections, Intra-Articular / Q000662:veterinary; D010147:Pain Measurement / Q000662:veterinary; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care / Q000662:veterinary; D011446:Prospective Studies; D016037:Single-Blind Method; D013264:Stifle / Q000601:surgery*
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D002045:Bupivacaine