Orthopedic surgery pain

WSAVA guideline

Key findings

• GA + "aggressive perioperative analgesia"; preventive, multimodal for all procedures; phase balance depends on pre-op condition and trauma location/magnitude (§3.3).
• NSAIDs: "excellent perioperative analgesia" — use unless contraindicated; prefer approved; same NSAID pre-/post-op, no perioperative switching (§3.3).
• LA techniques recommended in all cases; mandatory without controlled drugs; bupivacaine/ropivacaine preferred; liposomal bupivacaine ≤72 h for cruciate incisional analgesia (dog) (§3.3).
• Blocks as printed: RUMM, sciatic-femoral, incisional, brachial plexus, epidural; wound catheters; intra-op CRIs "may not be required if an effective local anaesthetic block has been performed" (Table 22).
• 24 h post-op: NSAID (if not pre-op) + tapered infusions + wound catheters + cold therapy, padding, massage; later: opioids titrated off, NSAIDs days–weeks, metamizole, paracetamol (not cats), gabapentin/amantadine/lidocaine patch; icing ≥3 days then heat (Table 22).
• Continuous intra-articular LA infusion contraindicated — cartilage damage, ascending infection (Table 22 footnote).
• Tiers: no-controlled — injectable tramadol, LA + IV lidocaine "critical"; limited — ketamine/lidocaine infusions, acupuncture, low-dose α2; euthanasia if severe prolonged unmanageable pain; post-discharge analgesia critical; ~25% dysphoria after fentanyl ortho CRI (Table 12).

Drugs named in WSAVA’s own guideline text

As printed in WSAVA’s document, not this app’s own extracted data — see “Related drugs in this reference” below for that.

• NSAID (approved) (Dog & Cat)

• Methadone (Dog)

• (Cat)

• Acepromazine / medetomidine (Dog / Cat)

• Propofol (Dog & Cat)

• Epidural morphine + bupivacaine 0.5% (Dog & Cat)

• Gabapentin (Dog)

• Buprenorphine (Cat)

• Bupivacaine/ropivacaine (Dog & Cat)

• Ketamine/lidocaine/opioid/α2 CRIs (Dog & Cat)

Recommendations

• GA + aggressive perioperative analgesia; preventive + multimodal for all procedures

  Expert consensus (GPC, §3.3)

• Locoregional techniques in all cases; mandatory when opioids unavailable

  Expert consensus (GPC)

• Prefer long-acting LAs; liposomal bupivacaine ≤72 h for cruciate incisional analgesia (dog)

  Expert consensus (GPC)

• NSAIDs unless contraindicated; same NSAID pre-/post-op, no switching

  Expert consensus (GPC)

• Perioperative gabapentin where nerve injury risks neuropathic/persistent post-op pain

  Expert consensus (human-based)

• Systemic intra-op drugs may be reduced/omitted after effective LA block

  Table 22 footnote (GPC)

• Taper infusions over 24 h; icing ≥3 days then heat; post-discharge analgesia critical

  Expert consensus (GPC)

• No continuous intra-articular LA infusion

  Contraindicated (Table 22 footnote)

Related drugs in this reference (1)

The quoted line under each drug is its own already-extracted indication text that matched this condition — the reason it’s listed, not a paraphrase. Open a drug for its full species/route breakdown, calculator, and complete adverse-effect list.

Showing 1 of 1 linked drug record. Open a record for species, route and source details.

• FIROCOXIB

  “OA pain/inflammation; post-op orthopedic pain”

  Source dose preview: 5 mg/kg, q24h, PO (Dog)

  Adverse-effect notes: Vomiting, anorexia — Most common (~4%, ~2% resp.) · Periportal hepatic fatty change — Juvenile/puppy chronic dosing studies