Wound Soaker Catheters
At the Foster Hospital for Small Animals and Tufts Veterinary Emergency Treatment and Specialties (Tufts VETS), we have been using wound soaker catheters routinely since 2004 for infusion of lidocaine (dogs) and intermittent bupivacaine injection in cats after a variety of procedures. These include limb amputation, ear canal ablation, intercostal and sternal thoracotomy, celiotomy, and soft tissue tumor excision.
Two of our anesthesiology/pain medicine specialists, Dr. Emily McCobb and Dr. Cheryl Blaze, collaborated with experts at Mila International (Erlanger, KY) to develop the competitively priced veterinary catheters. Qualitatively, we find that the pain relief afforded to patients is excellent. Dogs recovering from an intercostal thoracotomy will lie on the side of the incision, which suggests that they are quite comfortable. Perhaps the most compelling application is the use of wound soakers for limb amputation. In fact, the use of wound soaker catheters has become a common and preferred amputation pain management technique in many hospitals. Patients are comfortable upon recovery from anesthesia, will stand, walk and eliminate with ease, and generally will eat the first postoperative night.
It should be emphasized that we continue to use pre-, intra-, and postoperative multimodal analgesia, consisting of an intravenous opioid, ketamine or alpha 2 agonist infusion, and NSAIDS and/or epidural analgesia along with the wound soakers. However, we are able to reduce the amount of opioid medications and sedatives significantly. (See figures for views of patients managed with wound soaker catheters.)
In 2009, our group published a case series reviewing our experiences with the safety of the technique:
Abelson AL, McCobb EC, Shaw S, Armitage-Chan A, Wetmore LA, Karas AZ and Blaze C. (2009) Use of wound soaker catheters for the administration of local anesthetic for post-operative analgesia: 56 cases. Veterinary Anaesthesia and Analgesia. 36:597–602.
A study comparing recovery and rehabilitation pain in patients with and without wound infusion of local anesthetics is ongoing at the FHSA.