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Surgical Site Infiltration with Comfort-in Device and Traditional Syringe in Dogs Undergoing Regional Mastectomy: Evaluation of Intra- and Postoperative Pain and Oxidative Stress
by
, , , , , , and
Giovanna Lucrezia Costa
1,*,
Fabio Bruno
1,
Fabio Leonardi
2,*,
Patrizia Licata
1,
Francesco Macrì
1,
Rocío Fernández Parra
3,
Giuseppe Bruschetta
1,
Vincenzo Nava
1,
Michela Pugliese
1 and
Filippo Spadola
1 1
Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy
2
Department of Veterinary Science, University of Parma, Via del Taglio 10, 43126 Parma, Italy
3
Departamento de Cirugía y Medicina Animal, Universidad Catòlica de Valencia San Vicente Màrtir, 46018 Valencia, Spain
*
Authors to whom correspondence should be addressed.
Animals 2024, 14(13), 1902; https://doi.org/10.3390/ani14131902
Submission received: 30 May 2024
/
Revised: 21 June 2024
/
Accepted: 26 June 2024
/
Published: 27 June 2024
(This article belongs to the Special Issue Anesthesia and Analgesia in Companion Animals Surgery)
Simple Summary
The surgical site infiltration of a local anesthetic, defined as the direct injection of a drug into the surgical field, has proven to be effective in the management of intra- and postoperative pain as it allows one to reduce the use of additional analgesics, such as opioids and non-steroidal anti-inflammatory drugs. Tissue infiltration with local anesthetics is usually performed using a traditional syringe attached to a needle. Innovative devices such as Comfort-in® have been developed, and they do not require a needle. This technology is an injection system that works by infusion via a spring system. It releases the drug at high speed, creating a “fluid needle” that penetrates tissue in less than 1/3 of a second at an average pressure of 3900 pounds per square inch (psi). The depth of penetration depends on the volume of the drug, and the dispersion of the drug is uniform through nebulization. In human medicine, local anesthesia with a needle-free injection system has been used in infiltrations, incisions, dental extractions, urology, diabetology, virology, dermatology, and pediatrics. The needle-free injection system has recently been proposed as a valid alternative method also in veterinary medicine for vaccination and drug administration in swine.
Abstract
The surgical site infiltration of a local anesthetic is defined as the direct injection of a drug. This study aimed to compare the effects of surgical site infiltration with 4 mg kg−1 lidocaine using a Comfort-in device and traditional syringe on oxidative status and intra- and postoperative pain in dogs undergoing regional mastectomy. Sixty adult female dogs divided into C (Comfort-in device), S (traditional syringe), and CTR (control) groups received 2 µg kg−1 dexmedetomidine and 4 mg kg−1 tramadol IM, 5 mg kg−1 tiletamine/zolazepam IV, and isoflurane. The physiological and anesthesiological parameters were measured. The assessment of intra- and postoperative responses to the surgical stimulus was performed using a cumulative pain scale (CPS score of 0–4) and the Colorado Pain Scale (CSU-CAPS score of 0–4). The hematological and biochemical parameters and inflammatory oxidative status were measured. The CPS scores showed no significant differences between the C and S groups (p = 0.236), while the comparison between the CTR, C, and S groups, respectively, showed a significant difference (p < 0.001). The postoperative analgesia scores were significantly lower in the C group compared to those of the S and CTR groups (p < 0.001.). In the C group, no subject received rescue analgesia during the intra- and postoperative periods. The level of oxidative inflammatory stress was lower in group C than those in S and CTR groups, and no side effects were observed in all the groups.
