Aldrich et al: Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery
Veterinary Surgery 5, 2023

🔍 Key Findings

  • Liposomal bupivacaine (LB) infiltration did not reduce the need for rescue analgesia compared with placebo in dogs undergoing TPLO.
  • CMPS-SF pain scores were not significantly different between LB and placebo groups at any postoperative time point.
  • % body weight distribution (%BWdist) to the operated limb did not differ significantly between treatment groups across all time points.
  • No correlation was found between CMPS-SF scores and %BWdist, suggesting these metrics assess different aspects of postoperative pain.
  • Postoperative carprofen administration was standardized, and LB did not provide additional detectable analgesic benefit.
  • Three-layer infiltration technique (joint capsule, fascia, subcutis) was used consistently across all cases.
  • Adverse events were minor and comparable between LB and placebo groups.
  • Post hoc analysis suggested a much larger sample size (58–436 dogs) would be needed to detect significant differences in %BWdist.

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Aldrich et al: Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery
Veterinary Surgery 5, 2023

🔍 Key Findings

  • Liposomal bupivacaine (LB) infiltration did not reduce the need for rescue analgesia compared with placebo in dogs undergoing TPLO.
  • CMPS-SF pain scores were not significantly different between LB and placebo groups at any postoperative time point.
  • % body weight distribution (%BWdist) to the operated limb did not differ significantly between treatment groups across all time points.
  • No correlation was found between CMPS-SF scores and %BWdist, suggesting these metrics assess different aspects of postoperative pain.
  • Postoperative carprofen administration was standardized, and LB did not provide additional detectable analgesic benefit.
  • Three-layer infiltration technique (joint capsule, fascia, subcutis) was used consistently across all cases.
  • Adverse events were minor and comparable between LB and placebo groups.
  • Post hoc analysis suggested a much larger sample size (58–436 dogs) would be needed to detect significant differences in %BWdist.

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Multiple Choice Questions on this study

In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, what was the reported correlation between CMPS-SF scores and %BWdist?

A. No significant correlation
B. Strong positive correlation
C. Weak negative correlation
D. Strong inverse correlation
E. Only correlated at 12 hours

Answer: No significant correlation

Explanation: CMPS-SF scores and %BWdist were not significantly correlated at any time point.
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, how was analgesic success defined?

A. No need for rescue analgesia over 48 hours
B. CMPS-SF score ≤ 3
C. BWdist > 5% at 24 hours
D. Only requiring one opioid dose
E. Cage comfort score ≥ 5

Answer: No need for rescue analgesia over 48 hours

Explanation: Success was defined as not requiring rescue opioids within 48h post-op.
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, what conclusion was drawn about %BW distribution to the operated limb?

A. It did not differ significantly between groups
B. It was significantly higher in the LB group
C. It was lower in the placebo group on day 2
D. It increased over time only in the LB group
E. It correlated strongly with CMPS-SF

Answer: It did not differ significantly between groups

Explanation: No difference in %BWdist was found at any time point between LB and placebo dogs.
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, which metric showed no significant difference between treatment and placebo groups?

A. CMPS-SF pain scores
B. Mechanical nociception threshold
C. Vertical ground reaction force
D. Meniscal tear frequency
E. Tibial plateau angle

Answer: CMPS-SF pain scores

Explanation: CMPS-SF scores did not differ significantly between liposomal bupivacaine and placebo groups at any time point.
In Aldrich 2023 et al., on liposomal bupivacaine in TPLO, what limitation did the authors note regarding their ability to detect a treatment effect?

A. Underpowered sample size
B. Non-randomized design
C. Unblinded assessors
D. No placebo control
E. Incomplete CMPS-SF data

Answer: Underpowered sample size

Explanation: Post hoc power analysis revealed the sample was likely too small to detect a true difference.

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