VetMedPostoperative pain in dogs after abdominal surgery: does a lidocaine infusion improve pain scores vs standard analgesia? — POSSIBLE (the treatment made no difference)
In dogs after abdominal surgery, does a lidocaine CRI vs standard analgesia improve pain scores and GI motility?
Shelf #526 · gate-verified and displayed under the developer's blinded-trial rule
POSSIBLE (the treatment made no difference): Across three randomised trials in dogs undergoing ovariohysterectomy or ovariectomy, a lidocaine constant rate infusion (CRI) did not improve postoperative pain scores over standard analgesia — it matched an NSAID, it did not separate from a butorphanol control on pain scores, and added to an opioid it changed no pain or behaviour score. Gutierrez-Blanco 2015 (PMID: 25039918), a randomized, prospective, blinded clinical study in 54 dogs after ovariohysterectomy, compared CRIs of fentanyl, lidocaine (LIDO: 2 mg/kg bolus, then 100 μg/kg/minute, then 25 μg/kg/minute for a further 4 hours), ketamine, dexmedetomidine, a lidocaine-ketamine-dexmedetomidine combination, and a butorphanol control with saline infusion (CONTROL/BUT): dogs requiring rescue analgesia were CONTROL/BUT n = 8, ketamine n = 3, dexmedetomidine n = 2 and LIDO n = 2, with none in the combination or fentanyl groups, but CONTROL/BUT pain scores were significantly higher at 1 hour than fentanyl, dexmedetomidine and the combination — not than LIDO — and the authors conclude LIDO may not be effective for treatment of postoperative pain in dogs undergoing ovariohysterectomy. Tsai 2013 (PMID: 23837712), a prospective, randomized, double-blind, controlled clinical trial in 27 dogs (n = 9 per group) undergoing ovariohysterectomy, compared intravenous meloxicam, a lidocaine bolus (1 mg/kg) then CRI (0.025 mg/kg/minute), and both together: there were no significant differences in subjective pain scores, serum cortisol or glucose concentrations between the three groups, the highest pain score at any time was 5, and no dog required rescue analgesia. Columbano 2012 (PMID: 22261004), a randomized trial in 24 dogs undergoing ovariectomy under opioid-based balanced anaesthesia, added lidocaine CRI (2 mg/kg plus 50 μg/kg/min) or saline to buprenorphine or fentanyl: lidocaine produced a 14% decrease in end-tidal sevoflurane in the buprenorphine group (P < 0.01) but none in the fentanyl group, and no change in cardiopulmonary responses to surgery or postoperative behaviours and pain scores in any group. Design class (a): Tsai 2013 establishes randomisation AND double-blinding answering this shelf's own comparison (intravenous lidocaine CRI vs a standard analgesic, meloxicam) in this shelf's own population (dogs after abdominal surgery — ovariohysterectomy), and Gutierrez-Blanco 2015 establishes randomisation and blinding for its lidocaine arm against a standard-analgesia control. Narrowings stated on the face: (1) GI MOTILITY IS UNTESTED — the mined question asks about pain scores AND GI motility, but no fetched record in dogs measures gastrointestinal motility, ileus or gut recovery after lidocaine infusion (PubMed searches for lidocaine with canine gastrointestinal motility, ileus and enterectomy terms returned no eligible record), so this shelf's stamp and its 'made no difference' wording apply to pain scores only, and the equine postoperative-ileus lidocaine literature (shelves #179 and #835) is a different species and question and was not imported; (2) all carded surgery is ovariohysterectomy or ovariectomy — no carded record studies lidocaine CRI after gastrointestinal or other major abdominal surgery in dogs. The 'made no difference' wording is a true-null statement about IMPROVEMENT over comparators, not a claim that lidocaine provides no analgesia: in Tsai 2013 all three regimens were judged adequate with no rescue analgesia needed. The stamp is POSSIBLE rather than LIKELY because the trials are small (27 to 54 dogs), use differing comparators and scoring systems, and Gutierrez-Blanco 2015 contains a counter-signal on rescue analgesia (2 lidocaine dogs vs 8 control dogs required rescue) even though its pain scores did not separate. Near-misses, not carded: Lewis 2014 (PMID: 24739113), a randomized blinded trial of a morphine-lidocaine-ketamine CRI (a pooled three-drug combination) after stifle surgery — a pooled-class comparison cannot carry this single-drug shelf, the surgery is orthopaedic not abdominal, and the record is already homed at shelf #523, so it is cross-pointed, never re-carded; Morgaz 2014 (PMID: 25257353), continuous PRE-PERITONEAL WOUND INFUSION of lidocaine via a wound catheter vs intramuscular methadone after ovariohysterectomy (no intergroup pain-score differences; 4 control dogs vs 0 lidocaine dogs required rescue) — a locoregional wound-infusion route, not an intravenous CRI, and its evaluator was unblinded by the presence of the wound catheter; Wolfe 2006 (PMID: 16916355), constant-rate LOCAL lidocaine delivery vs intravenous morphine after total ear canal ablation — local delivery, and ear surgery is not abdominal surgery. Boundary respected: ketamine CRI in dogs is a different drug and homes at shelf #525; its records were not imported. Tier C adjudication, recorded on the face: Tier C is NOT engaged — no carded record makes a mortality or survival-primary benefit claim; pain scores, rescue analgesia and anaesthetic requirement are the outcomes throughout. Drafted Nov 10, 2026 (VetMed build, topic #526); figures from the abstracts fetched and verified at drafting.
Gutierrez-Blanco 2015: lidocaine CRI did not separate from a butorphanol control on pain scores after ovariohysterectomy in a randomized blinded trial of 54 dogs — control pain scores at 1 hour were higher than fentanyl, dexmedetomidine and the triple combination, but not than lidocaine
Randomized Controlled Trial (the record's own publication types: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't), described in the record as a randomized, prospective, blinded, clinical study. Randomisation and blinding are stated; the blinded parties are not specified in the abstract.
Who: Dogs: 54 dogs undergoing ovariohysterectomy in a randomized, prospective, blinded clinical study. Anaesthesia was induced with propofol and maintained with isoflurane. Each treatment was an intravenous bolus at the start of anaesthesia, then an IV CRI until the end of anaesthesia, then a CRI at a decreased dose for a further 4 hours: CONTROL/BUT (butorphanol 0.4 mg/kg, saline infusion 2 mL/kg/hour); fentanyl (5 μg/kg, 10 μg/kg/hour, then 2.5 μg/kg/hour); ketamine (1 mg/kg, 40 μg/kg/minute, then 10 μg/kg/minute); LIDO (lidocaine 2 mg/kg, 100 μg/kg/minute, then 25 μg/kg/minute); dexmedetomidine (1 μg/kg, 3 μg/kg/hour, then 1 μg/kg/hour); or the lidocaine-ketamine-dexmedetomidine combination at the same doses. Postoperative analgesia was evaluated using the Glasgow composite pain scale, the University of Melbourne pain scale and a numerical rating scale; rescue analgesia was morphine and carprofen. Design facts: the record states a randomized, blinded design; it does not specify in its abstract which personnel were blinded.
Result: Animals requiring rescue analgesia included CONTROL/BUT (n = 8), ketamine (n = 3), dexmedetomidine (n = 2), and LIDO (n = 2); significantly higher in CONTROL/BUT than other groups. No dogs in the combination and fentanyl groups received rescue analgesia. CONTROL/BUT pain scores were significantly higher at 1 hour than fentanyl, dexmedetomidine and the combination, but not than ketamine or LIDO. Fentanyl and combination sedation scores were higher than CONTROL/BUT at 1 hour. The authors conclude the combination and fentanyl resulted in adequate postoperative analgesia, and that LIDO, CONTROL/BUT, ketamine and dexmedetomidine may not be effective for treatment of postoperative pain in dogs undergoing ovariohysterectomy.
Watch out: TWO SIGNALS POINT DIFFERENT WAYS IN THE SAME TRIAL: lidocaine dogs needed rescue analgesia far less often than butorphanol controls (2 vs 8 dogs), yet lidocaine was one of only two active treatments whose pain scores did NOT separate from control at 1 hour, and the authors grouped lidocaine with the treatments that 'may not be effective'. Read the card as 'no pain-score improvement shown', not as proof lidocaine contributed nothing — and note the control was butorphanol plus saline, a weak standard, which makes the failure to separate on scores more telling, not less.
Gutierrez-Blanco E, Victoria-Mora JM, Ibancovichi-Camarillo JA, Sauri-Arceo CH, Bolio-González ME, Acevedo-Arcique CM, Marin-Cano G, Steagall PV. Postoperative analgesic effects of either a constant rate infusion of fentanyl, lidocaine, ketamine, dexmedetomidine, or the combination lidocaine-ketamine-dexmedetomidine after ovariohysterectomy in dogs. Vet Anaesth Analg. 2015;42(3):309-18. PMID: 25039918. Registry ID: none in the record. MeSH: Analgesia/veterinary* · Analgesics, Non-Narcotic/administration & dosage, pharmacology · Anesthetics, Dissociative/administration & dosage, pharmacology · Anesthetics, Inhalation/administration & dosage · Anesthetics, Intravenous/administration & dosage, pharmacology · Anesthetics, Local/administration & dosage, pharmacology · Animals · Dexmedetomidine/administration & dosage, pharmacology* · Dogs · Drug Combinations · Female · Fentanyl/administration & dosage, pharmacology* · Hysterectomy/veterinary · Ketamine/administration & dosage, pharmacology* · Lidocaine/administration & dosage, pharmacology* · Ovariectomy/veterinary · Postoperative Pain/prevention & control, veterinary*
Tsai 2013: intravenous lidocaine CRI, meloxicam, and their combination gave indistinguishable pain scores after ovariohysterectomy in a randomized double-blind trial of 27 dogs — no dog in any group needed rescue analgesia
Randomized Controlled Trial (the record's own publication types: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't), described in the record as a prospective, randomized, double-blind, controlled clinical trial. Randomisation and double-blinding are stated.
Who: Dogs: 27 dogs aged (mean ± SD) 16.1 ± 7.5 months and weighing 22.4 ± 17.9 kg scheduled for ovariohysterectomy, in a prospective, randomized, double-blind, controlled clinical trial. Anaesthesia was induced with propofol and maintained with isoflurane. Dogs (n = 9 in each group) received just prior to and during surgery one of: M group, 0.2 mg/kg IV meloxicam then a CRI of lactated Ringer's at 10 mL/kg/hour; L group, a bolus of lidocaine (1 mg/kg IV) then a CRI of lidocaine at 0.025 mg/kg/minute; or M + L group, both treatments. Pain and sedation were scored and venous samples taken for serum cortisol and glucose before and at intervals for 12 hours after anaesthesia; pain was assessed using a multi-parameter subjective scoring scale (cumulative scale 0–21) by three observers, with rescue analgesia protocolised for a total score exceeding 9 or a sub-score above 3 in any category. Sedation was scored on a scale of 0–4.
Result: There were no significant differences in subjective pain scores, serum cortisol, and glucose concentrations between the three groups. The highest pain score at any time was 5, and no dog required rescue analgesia. None of the three regimens caused any observable side effects during or after anaesthesia. At 1 and 2 hours after extubation dogs in group L were significantly more sedated than in the other two groups. The authors conclude IV lidocaine and meloxicam provide similar and adequate post-operative analgesia in healthy dogs undergoing ovariohysterectomy.
Watch out: A LOW-PAIN MODEL WITH A FLOOR EFFECT: ovariohysterectomy in young healthy dogs produced a highest pain score of only 5 of 21 in any group, so the trial could show the regimens are similarly adequate but had little room to show any treatment improving on another; lidocaine dogs were also significantly more sedated at 1 and 2 hours, which can itself lower behaviour-based pain scores.
Tsai TY, Chang SK, Chou PY, Yeh LS. Comparison of postoperative effects between lidocaine infusion, meloxicam, and their combination in dogs undergoing ovariohysterectomy. Vet Anaesth Analg. 2013;40(6):615-22. PMID: 23837712. Registry ID: none in the record. MeSH: Analgesia/methods, veterinary* · Analgesics*/administration & dosage · Animals · Dogs/surgery* · Double-Blind Method · Drug Therapy, Combination · Female · Hysterectomy/veterinary* · Infusions, Intravenous · Lidocaine*/administration & dosage · Meloxicam · Ovariectomy/veterinary* · Pain Measurement/veterinary · Postoperative Pain/drug therapy* · Postoperative Period · Thiazines*/administration & dosage · Thiazoles*/administration & dosage
Columbano 2012: adding a lidocaine CRI to opioid-based balanced anaesthesia changed no postoperative pain or behaviour score in 24 dogs undergoing ovariectomy, in a randomized trial
Randomized Controlled Trial (the record's own publication types: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't). Randomisation is stated; blinding is recorded in MeSH as Single-Blind Method — the record does not state in its abstract who was blinded.
Who: Dogs: 24 dogs scheduled for elective ovariectomy, randomly assigned to one of four groups: BC, buprenorphine without lidocaine; FC, fentanyl without lidocaine; BL, buprenorphine and lidocaine; FL, fentanyl and lidocaine. Dogs were anesthetized with intravenous diazepam and ketamine and anaesthesia maintained with sevoflurane in oxygen/air. Lidocaine (2 mg/kg plus 50 μg/kg/min) or saline were infused in the lidocaine and control groups respectively; after initiation of the lidocaine or saline CRI, buprenorphine (0.02 mg/kg IV) or a fentanyl bolus plus CRI (4 μg/kg plus 8 μg/kg/hour) were administered. Respiratory and hemodynamic variables, drug plasma concentrations and end-tidal sevoflurane concentrations were measured; behaviours and pain scores were subjectively assessed 1 and 2 hours post-extubation. Design facts: random assignment is stated; MeSH records Single-Blind Method.
Result: Lidocaine CRI produced median drug plasma concentrations < 0.4 μg/mL during peak surgical stimulation. Lidocaine produced a 14% decrease in end-tidal sevoflurane in the BL group (P < 0.01) but none in the FL group, and no change in cardio-pulmonary responses to surgery or postoperative behaviors and pain scores in any group. The authors conclude that, depending on the opioid used, supplementing opioid-based balanced anesthesia with lidocaine (50 μg/kg/min) may not have any or only a minor impact on anesthetic outcome in terms of total anesthetic dose, autonomic responses to visceral nociception, and postoperative analgesia.
Watch out: AN ADD-ON QUESTION WITH A SHORT WINDOW: this card tests lidocaine added ON TOP of an opioid (a different comparison from lidocaine instead of standard analgesia), pain was assessed only at 1 and 2 hours post-extubation, plasma lidocaine concentrations were low (< 0.4 μg/mL at peak stimulation), and the one positive finding — a 14% relative reduction in end-tidal sevoflurane — appeared with buprenorphine only and is an anaesthetic-requirement measure, not a pain outcome.
Columbano N, Secci F, Careddu GM, Sotgiu G, Rossi G, Driessen B. Effects of lidocaine constant rate infusion on sevoflurane requirement, autonomic responses, and postoperative analgesia in dogs undergoing ovariectomy under opioid-based balanced anesthesia. Vet J. 2012;193(2):448-55. PMID: 22261004. Registry ID: none in the record. MeSH: Analgesia/veterinary · Analgesics, Opioid/administration & dosage* · Anesthetics, Inhalation/administration & dosage* · Anesthetics, Intravenous/administration & dosage · Anesthetics, Local/administration & dosage* · Animals · Balanced Anesthesia/methods*, veterinary · Buprenorphine/administration & dosage · Dogs · Female · Fentanyl/administration & dosage · Infusions, Intravenous/veterinary · Lidocaine/administration & dosage* · Methyl Ethers/administration & dosage* · Ovariectomy/veterinary · Postoperative Pain/drug therapy, veterinary · Prospective Studies · Sevoflurane · Single-Blind Method
Synthesis: lidocaine CRI matches standard analgesia but does not improve on it for postoperative pain scores in dogs — and its effect on canine GI motility has never been tested in a cardable record
Synthesis
Who: Dogs: synthesis of the three carded randomised trials after abdominal surgery — Gutierrez-Blanco 2015 (54 dogs, ovariohysterectomy, lidocaine CRI vs butorphanol/saline control within a six-arm blinded trial), Tsai 2013 (27 dogs, ovariohysterectomy, lidocaine CRI vs meloxicam vs both, double-blind) and Columbano 2012 (24 dogs, ovariectomy, lidocaine CRI added to buprenorphine or fentanyl vs saline). No carded record measures gastrointestinal motility.
Result: No trial found a pain-score advantage for lidocaine: scores were indistinguishable from meloxicam (Tsai 2013, with no rescue analgesia needed in any group), unchanged when lidocaine was added to an opioid (Columbano 2012), and not separated from a butorphanol control at the single time point where other treatments did separate (Gutierrez-Blanco 2015), although fewer lidocaine dogs than control dogs required rescue analgesia in that trial (2 vs 8). The shelf is therefore stamped POSSIBLE (the treatment made no difference) for the pain-score question: three randomised trials, two of them blinded or double-blinded, converge on no improvement over standard analgesia, which is moderate evidence of no added benefit — not LIKELY-grade, because the trials are small, comparators and scales differ, and the rescue-analgesia counter-signal is unexplained; and not MAYBE (weak evidence), because the null is consistent across independent randomised comparisons rather than resting on a single weak record. The GI-motility half of the question is honestly unanswered by any carded record and carries no stamp implication either way.
Watch out: 'Made no difference' means no improvement OVER standard analgesia — lidocaine-treated dogs in Tsai 2013 had adequate analgesia with no rescue needed, so do not read this shelf as 'lidocaine does not work'. Nothing here speaks to GI surgery, to ileus, or to gut recovery: those canine records do not exist in the fetched literature, and the equine ileus evidence must not be borrowed for dogs.
Synthesis of Gutierrez-Blanco et al. PMID: 25039918; Tsai et al. PMID: 23837712; Columbano et al. PMID: 22261004. Registry IDs as on the individual cards (none in the records).
Back to the library index · VetMed home
VetMed is an educational resource, not veterinary advice.