Bupivacaine Liposomal Injectable Suspension (Nocita®) via Transversus Abdominis Plane (TAP) Block for Management of Pain in Dogs with Acute Pancreatitis: A Pilot Study

Abdominal pain is one of the most salient features of acute pancreatitis (AP) in dogs. While traditional opioids provide excellent analgesia, they are also associated with significant adverse effects, including ileus. The transversus abdominis plane (TAP) block has been shown to manage pain associated with AP in humans. Ten client-owned dogs with naturally occurring AP were enrolled in a blinded placebo-controlled clinical trial, receiving either a TAP block with bupivacaine liposome injectable suspension (n = 5) or traditional opioid analgesia (n = 5). Rescue analgesia was administered when indicated based on pain score monitoring every 4 h. Each dog was also administered an imaging device to track gastrointestinal transit time (GITT). The total opioid dose during the 72 h study period was significantly lower in the TAP block group (0.18 ± 0.27 mg/kg) compared to the control (0.99 ± 0.50 mg/kg) group (p = 0.01). GITT was prolonged in both the TAP block group (2/3) and the control group (4/5) compared to published references for healthy dogs. Bupivacaine liposomal injectable suspension administered via TAP block may provide sufficient analgesia in dogs with AP while also minimizing their total opioid requirements. Delayed gastric transit was common in both groups, suggesting that factors beyond just opioid administration contribute to gastrointestinal dysmotility in dogs with AP.