Background: Local anesthetics are an important component of perioperative pain management, but the duration\nof action of available products is limited. We hypothesized that a single local infiltration of a novel bupivacaine\nliposome injectable suspension (AT-003) would provide clinically effective analgesia over a 72-h period.\nIn a masked, randomized, placebo-controlled, multi-center pilot field study, dogs undergoing lateral retinacular\nsuture placement for cranial cruciate insufficiency were randomly assigned to surgical site infiltration with AT-003\n(5.3 mg/kg) or an equivalent volume of saline. Infiltration of the surgical site was done prior to closure. Primary\noutcome measure was the Glasgow Composite Measure Pain Scale (CMPS-SF) assessed prior to surgery and at\n2, 4, 8, 12, 24, 30, 36, 48, 54, 60 and 72 h following surgery by trained individuals. Provision for rescue analgesia was\nemployed. Repeated measures analysis of variance were utilized to test for possible differences between treatment\ngroups and a success/failure analysis was also employed, based on the need for rescue analgesia.\nResults: Forty-six dogs were enrolled and evaluated. For CMPS-SF scores there was a significant overall treatment\neffect (p = 0.0027) in favor of AT-003. There were significantly more successes in the AT-003 group compared to\nplacebo over each time period (p = 0.0001 for 0ââ?¬â??24 h, p = 0.0349 for 0ââ?¬â??48 h, and p = 0.0240 for 0-72 h). No\nsignificant adverse events were seen.\nConclusions: AT-003 (bupivacaine liposome injectable suspension) provided measurable local analgesia over a 72-h\nperiod following post-stifle surgery surgical site tissue infiltration. Further work is indicated to develop this product\nfor clinical use.
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