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The effect of extracorporeal shockwave on liposomal bupivacaine in a tibial plateau leveling osteotomy model
Author(s) -
Frederick Steven W.,
Cross Alan R.
Publication year - 2020
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13507
Subject(s) - medicine , bupivacaine , anesthesia , osteotomy , extracorporeal , saline , surgery , urology
Objective To determine the effect of extracorporeal shock wave (ESWT) on liposomal bupivacaine in a tibial‐plateau‐leveling osteotomy model. Study design In vitro study. Sample population Ten samples per group. Methods In addition to a control group (sham treatment), five treatment groups were defined as A, energy (E) 3 (0.22 mJ/mm 2 ), 360 pulses per minute (p/m); B, E6 (0.29 mJ/mm 2 ), 360 p/m; C, E8 (0.39 mJ/mm 2 ), 360 p/m; D, E6, 480 p/m; E, E8 480 p/m. Two‐milliliter aliquots of liposomal bupivacaine were placed in a gelatin chamber and treated with 1000 pulses according to group. All samples remained in the chamber for 170 seconds to reflect the longest treatment group. Free bupivacaine concentrations were determined after treatment with high‐performance liquid chromatography. Results The median free bupivacaine concentration was reported as control, 1.90 mg/mL; A, 2.10 mg/mL; B, 2.03 mg/mL; C, 2.94 mg/mL; D, 2.71 mg/mL; E, 4.35 mg/mL. Groups C ( P = .027), D ( P = .034), and E ( P = .002) were different from the control group. Groups C ( P = .0025) and D ( P = .0025) were different from group E. Additional intertreatment group differences were found. Conclusion Extracorporeal shock wave therapy caused a dose‐dependent release of bupivacaine; however, there was no significant release of bupivacaine from liposomes when ESWT was applied at currently recommended therapeutic settings in this model. Clinical significance This in vitro study provides evidence that concurrent electrohydraulic ESWT and liposomal bupivacaine is likely safe at currently recommended settings, however, higher energy and pulse frequency settings should be avoided.