QUARTERLY BEAT / APRIL 2022 ///
SAVED YOU A SEAT.
5 The clinical properties of the local anesthetic drugs are listed in Table 1. Choose the drug that fits your needs. Lidocaine has the fastest onset, but shortest duration, of action, which is often less than ideal. In most instances longer duration drugs should be chosen to decrease pain both intraoperatively and in recovery. Bupivacaine and ropivacaine provide slightly slower onset than lidocaine but longer duration. The onset time can be countered by doing the block early, e.g., prior to final surgical scrub. For the longest duration blockade, liposome-encapsulated bupivacaine (NOCITA® is the only veterinary drug in this category) provides analgesia for up to 72 hours. This has a further benefit in that pain after discharge can be controlled, in part, by the local anesthetic. More information on the drugs, including NOCITA®, and appropriate blocks is available. 1,3
Recommended reading: 1.
Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1). Vet Med Sci. 2020 May;6(2):209-217. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC7196681/ Proprietary market research, Elanco Animal Health, 2021. 2. Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Vet Med Sci. 2020 May;6(2):218-234. Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1). Vet Med Sci. 2020 May;6(2):209-217. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC7196681 Proprietary market research, Elanco Animal Health, 2021. 2. References: 1. Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Vet Med Sci. 2020 May;6(2):218-234. https://pubmed.ncbi.nlm.nih.gov/31965749/ 3. Mathews K, Kronen PW, Lascelles D, Nolan A, Robertson S, Steagall PV, Wright B, Yamashita K. Guidelines for recognition, assessment and treatment of pain. J Small Anim Pract. 2014 Jun;55(6):E10-68. https://wsava.org/Global-Guidelines/Global-Pain-Council-Guidelines/ 4. Otero P, Portela DA. (2018). Manual of small animal regional anesthesia: Illustrated anatomy for nerve stimulation and ultrasound-guided nerve blocks. 5. https://www.elanco.us/products-services/dogs/nocita, Accessed March 1, 2022.
Now you are ready to help all painful patients by using your superpower – the local anesthetics!
Table 1: Clinical properties of commonly used local anesthetic drugs
DOSE (mg/kg)
ONSET (mins)
DURATION 9hrs)
DRUG
Lidocaine
4-6 dogs; 2-4 cats
< 5
1-2
Bupivacaine
1-2 dogs; 0.5-1 cats 5-10
4-6
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Ropivacaine
1-2 dogs; 0.5-1 cats 5-10
4-6
Mepivacaine
3-5 dogs; 2-3 cats
2-5
2-3
NOCITA® (bupivacaine)
5.3 dogs; 5.3/foreleg for 10.6 total cats
Within 2-5*
72
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*Human data (Apseloff et al. 2013). not measure in animals
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