Ovariohysterectomy in dogs: does intraperitoneal bupivacaine versus saline reduce postoperative pain? — POSSIBLE

In dogs undergoing ovariohysterectomy, does intraperitoneal bupivacaine vs saline reduce postoperative pain scores?

Shelf #529 · gate-verified and displayed under the developer's blinded-trial rule

POSSIBLE: Three small randomised saline-controlled trials, in three different surgical settings, all found lower early postoperative pain scores with intraperitoneal (IP) bupivacaine. Campagnol 2012 (PMID: 22642413; 30 dogs, conventional ovariohysterectomy, blinded observer) found a lower visual analog scale (VAS) pain score at 1 hour with IP bupivacaine 5 mg/kg (median 0.3, interquartile range 0.0-2.6) than with saline control (median 6.4, 3.1-7.9), with rescue morphine given to 3/10 IP dogs versus 7/10 control dogs over 24 hours (a difference that did not reach significance among groups). Kim 2012 (PMID: 21397535; 16 dogs, laparoscopic ovariohysterectomy) found significantly lower Glasgow composite pain scores (CMPS-SF) with sprayed IP bupivacaine 4.4 mg/kg than with saline at 1, 2, 4, 6 and 12 hours. Carpenter 2004 (PMID: 14756753; 30 dogs) found significantly lower overall VAS pain scores with bupivacaine (given intraperitoneally plus incisionally) than with saline, with supplemental analgesia needed by 2/10 bupivacaine dogs versus 7/10 saline dogs. Design class (a): randomisation and blinded assessment are established by a carded record answering the shelf's own comparison and population — Campagnol 2012 states dogs were randomly assigned and pain was evaluated by a blinded observer, and Carpenter 2004 is a randomised, blinded (single-blind) controlled trial of the same comparison. The stamp is POSSIBLE, not higher, because the trials are small (10 dogs per arm in the two open-surgery trials; 16 dogs in total in the laparoscopic trial, whose per-arm split is not stated in the record), use different doses (4.4 to 5 mg/kg), routes of delivery (instilled vs sprayed) and operations (conventional vs laparoscopic), the clearest effect in the conventional-surgery trial is at 1 hour only, rescue-analgesia differences did not reach significance where tested, and one of the three trials (Carpenter 2004) combined intraperitoneal with incisional bupivacaine so its effect cannot be attributed to the intraperitoneal route alone. Drafted Nov 10, 2026 (VetMed build, topic #529); all figures from the abstracts fetched and verified at drafting.

Campagnol 2012: intraperitoneal bupivacaine lowered pain at 1 hour after ovariohysterectomy — median VAS 0.3 with IP bupivacaine versus 6.4 with saline control in 30 dogs; rescue morphine was needed by 3/10 IP dogs versus 7/10 controls over 24 hours (not significant among groups)

Prospective, randomized clinical study with blinded pain assessment (record's own wording; publication type: Journal Article)

Who: Dogs: 30 female dogs undergoing elective ovariohysterectomy, anaesthetised with acepromazine, butorphanol, thiopental and halothane. Dogs were randomly assigned to one of three groups (n = 10 per group): control (incisional and intraperitoneal 0.9% saline), IP group (incisional saline and intraperitoneal bupivacaine 5 mg/kg), or INC group (incisional bupivacaine 1 mg/kg with epinephrine and intraperitoneal saline). Postoperative pain was evaluated by a blinded observer for 24 hours after extubation using a visual analog scale (VAS) and a numeric rating scale (NRS); rescue morphine (0.5 mg/kg intramuscularly) was given if VAS was >5/10 or NRS >10/29.

Result: At 1 hour after anaesthesia, VAS pain scores (medians, interquartile range) were 6.4 (3.1-7.9) in the control group, 0.3 (0.0-2.6) in the IP group and 0.0 (0.0-7.0) in the INC group; VAS pain scores were lower in the IP group compared to the control group. Over the first 24 hours, rescue analgesia was administered to 7/10 control dogs, 5/10 INC dogs and 3/10 IP dogs; the total number of dogs given rescue analgesia did not differ significantly among groups. The authors conclude that intraperitoneal bupivacaine resulted in lower pain scores during the first hour of the postoperative period, with a trend towards a decreased need for rescue analgesia.

Watch out: The statistically supported pain advantage for the intraperitoneal route in this trial is confined to the first hour after anaesthesia, on a visual analog scale; the numeric rating scale results and the rescue-analgesia contrast (3/10 vs 7/10) did not differ significantly among groups, and with 10 dogs per group the rescue comparison is imprecise. All dogs also received acepromazine and butorphanol, so the result is for bupivacaine added to that protocol, not bupivacaine alone.

Campagnol D, Teixeira-Neto FJ, Monteiro ER, Restitutti F, Minto BW. Effect of intraperitoneal or incisional bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs. Vet Anaesth Analg. 2012;39(4):426-30. PMID: 22642413. Registry ID: none in the record. MeSH: Analgesia/methods, veterinary* · Anesthetics, Local/administration & dosage* · Animals · Bupivacaine/administration & dosage* · Procedural Sedation/methods, veterinary · Dog Diseases/surgery* · Dogs · Female · Hysterectomy/veterinary* · Infusions, Parenteral/veterinary · Ovariectomy/veterinary* · Pain Measurement · Postoperative Pain/prevention & control, veterinary*

Kim 2012: sprayed intraperitoneal bupivacaine lowered Glasgow pain scores after laparoscopic ovariohysterectomy — CMPS-SF significantly lower than saline at 1, 2, 4, 6 and 12 hours in 16 dogs

Randomized controlled trial (publication types: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't; the abstract does not state that pain assessors were blinded)

Who: Dogs: 16 sexually intact female dogs undergoing laparoscopic ovariohysterectomy, randomly assigned to two groups. The sprayed intraperitoneal bupivacaine (SIB) group received 4.4 mg/kg of sprayed intraperitoneal bupivacaine diluted to 0.25% with an equivalent volume of saline after pneumoperitoneum; the control group received 1.76 mL/kg of saline in a similar fashion. Both groups received preoperative periportal 5% bupivacaine (1 mL) before incision. Postoperative pain was measured using the short form of the Glasgow composite measures pain scale (CMPS-SF, 0-24), and serum cortisol and glucose were measured preoperatively and at 0.5, 1, 2, 4, 6, 12 and 24 hours postoperatively.

Result: The SIB group had significantly lower CMPS-SF scores compared to the control group at 1, 2, 4, 6 and 12 hours after the operation. Cortisol concentrations were significantly increased from preoperative concentrations in the control group at 0.5, 1, 2 and 4 hours post operation, and at 0.5 and 1 hour post operation in the SIB group. No significant differences were seen in serum glucose within each group. The authors conclude that sprayed intraperitoneal bupivacaine can be used as part of a multimodal approach for pain management after laparoscopic ovariohysterectomy in dogs.

Watch out: Only 16 dogs, and the operation is laparoscopic ovariohysterectomy — a less painful procedure than the conventional open operation in the other two cards — so the duration of benefit (to 12 hours) may not transfer to open surgery. The abstract reports that scores were significantly lower without printing the absolute CMPS-SF values, so the size of the pain-score difference cannot be judged from the record, and both groups also received periportal bupivacaine before incision.

Kim YK, Lee SS, Suh EH, Lee L, Lee HC, Lee HJ, Yeon SC. Sprayed intraperitoneal bupivacaine reduces early postoperative pain behavior and biochemical stress response after laparoscopic ovariohysterectomy in dogs. Vet J. 2012;191(2):188-92. PMID: 21397535. Registry ID: none in the record. MeSH: Administration, Topical · Anesthetics, Local/administration & dosage* · Animals · Bupivacaine/administration & dosage* · Dogs/physiology, surgery* · Female · Hysterectomy/veterinary · Laparoscopy/veterinary · Ovary/surgery · Pain Measurement/veterinary · Postoperative Pain/prevention & control* · Peritoneum · Treatment Outcome

Carpenter 2004: bupivacaine given intraperitoneally plus incisionally gave lower overall VAS pain scores than saline after ovariohysterectomy — supplemental analgesia needed by 2/10 bupivacaine dogs versus 7/10 saline dogs in 30 dogs

Prospective, randomized, controlled, blinded clinical trial (record's own wording; publication types: Clinical Trial, Journal Article, Randomized Controlled Trial)

Who: Dogs: 30 dogs presenting to a veterinary teaching hospital for elective ovariohysterectomy, premedicated with acepromazine and butorphanol, induced with thiopental and maintained with isoflurane. Dogs were randomly assigned to three groups of 10: lidocaine 8.8 mg/kg 2% with epinephrine intraperitoneally (LID), bupivacaine 4.4 mg/kg 0.75% intraperitoneally (BUP), or 0.9% saline intraperitoneally (SAL), given upon completion of ovariohysterectomy, with all intraperitoneal doses standardised to 0.88 mL/kg with saline; an additional 2 mL of undiluted solution was placed subcutaneously prior to incisional closure in every group. Dogs were scored at 0.5, 1, 2, 3, 6, 8 and 18 hours post-extubation by one observer using a visual analogue scale (VAS) for pain and sedation and a composite pain scale (CPS); dogs with VAS pain score >50 received supplemental butorphanol plus acepromazine.

Result: Peak post-surgical pain scores for all groups occurred at 0.5 hours and returned to baseline by 18 hours. Dogs in the BUP group had significantly lower VAS-pain scores overall than dogs in the SAL group. Seven out of 10 dogs in the SAL group, 4/10 in the LID group and 2/10 in the BUP group were treated with supplemental acepromazine and butorphanol. No differences between groups were detected with the composite pain scale. No adverse side-effects were observed. The authors conclude the findings support the use of intraperitoneal and subcutaneous bupivacaine for post-operative analgesia following ovariohysterectomy in the dog.

Watch out: The bupivacaine intervention in this trial is intraperitoneal PLUS incisional (subcutaneous) bupivacaine, so the benefit cannot be attributed to the intraperitoneal route alone — it is carded because the saline group received the same combined-route saline treatment, making it a bupivacaine-versus-saline test of the instillation protocol as a whole. The two pain instruments disagreed: the VAS favoured bupivacaine, the composite pain scale showed no difference between groups. Groups are 10 dogs each.

Carpenter RE, Wilson DV, Evans AT. Evaluation of intraperitoneal and incisional lidocaine or bupivacaine for analgesia following ovariohysterectomy in the dog. Vet Anaesth Analg. 2004;31(1):46-52. PMID: 14756753. Registry ID: none in the record. MeSH: Anesthetics, Local/administration & dosage* · Animals · Bupivacaine/administration & dosage* · Dogs/physiology*, surgery · Female · Hysterectomy/veterinary* · Injections/veterinary · Injections, Intraperitoneal/veterinary · Lidocaine/administration & dosage* · Ovariectomy/veterinary · Pain Measurement/veterinary · Postoperative Pain/prevention & control, veterinary* · Prospective Studies · Single-Blind Method · Treatment Outcome

Synthesis: three small randomised saline-controlled trials agree that intraperitoneal bupivacaine lowers early pain scores after ovariohysterectomy — POSSIBLE

Synthesis

Who: Synthesis of the three cards above: Campagnol 2012 (30 dogs, open ovariohysterectomy, IP bupivacaine 5 mg/kg vs saline, blinded observer), Kim 2012 (16 dogs, laparoscopic ovariohysterectomy, sprayed IP bupivacaine 4.4 mg/kg vs saline) and Carpenter 2004 (30 dogs, open ovariohysterectomy, IP plus incisional bupivacaine 4.4 mg/kg vs saline, single-blind).

Result: (1) Pain scores: lower with bupivacaine in all three trials — at 1 hour on VAS in open surgery (median 0.3 vs 6.4, Campagnol 2012), at 1 to 12 hours on CMPS-SF in laparoscopic surgery (Kim 2012, absolute values not printed in the abstract), and overall on VAS across 18 hours (Carpenter 2004), although Carpenter's composite pain scale showed no difference. (2) Rescue/supplemental analgesia: 3/10 vs 7/10 (Campagnol 2012, not significant among groups) and 2/10 vs 7/10 (Carpenter 2004). (3) Safety: no adverse side-effects were observed in Carpenter 2004; the other abstracts report no adverse-effect signal. (4) Design class (a): randomisation and blinded assessment are established by carded records (Campagnol 2012; Carpenter 2004) answering this shelf's own comparison in this shelf's own population.

Watch out: One-home check at drafting: PMIDs 22642413, 21397535 and 14756753 do not appear in any other pack on disk. Records deliberately not carded as claim-carriers: Lambertini 2018 (PMID: 30301661) and Kalchofner Guerrero 2016 (PMID: 26870925) compare intraperitoneal bupivacaine with ropivacaine, or test adding incisional bupivacaine when all dogs already received intraperitoneal bupivacaine — different comparisons with no saline-only arm; Quesada 2026 (PMID: 42914770) compares a quadratus lumborum block with intraperitoneal bupivacaine, again with no saline arm; and the ropivacaine-versus-saline record Kazmir-Lysak 2023 (PMID: 37822246), which found no difference in pain scores for ropivacaine, concerns a different drug and homes on its own question if built. All carded trials predate modern multimodal protocols in part (several dogs still needed rescue analgesia), doses and delivery differ across trials, and no carded trial follows pain beyond 24 hours.

Synthesis of Campagnol D et al. PMID: 22642413; Kim YK et al. PMID: 21397535; Carpenter RE et al. PMID: 14756753. Registry IDs as on the individual cards.

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