We started ultrasound‑guided femoral/sciatic blocks for TPLOs and ring blocks for mastectomies last month, and have cut fentanyl CRI time by about 50% with calmer extubations and earlier sternal recovery. Is anyone else pairing liposomal bupivacaine infiltration with NSAIDs and seeing less wind‑up and fewer rescue hydromorphone doses in PACU?
We’ve been doing Nocita infiltration along the mastectomy line (and drain tract) with pre‑op carprofen and saw about 40% fewer hydromorphone rescues — diluting 1:1 with saline helps spread, like turning down the static before the show… Small caveat: don’t stack non‑liposomal locals at the same site — if you line‑block with lidocaine, wait about 20 min before Nocita; label here: Products — are you also running a tiny ketamine CRI during closure?
And one tweak that cut our rescues: if we use lidocaine for the ring block, we place it first and then wait about 20 minutes before infiltrating Nocita along the incision — “20 min after lido” — to avoid liposome interference; with pre‑op carprofen, extubations are calmer and hydro in PACU is uncommon. Small caveat: if a drain’s going in, I stay superficial with the Nocita so it doesn’t just wick out — have you noticed any difference around drains?
Quick example: we boosted dental home‑care by doing a 60‑second “toothbrushing tryout” before discharge and sending owners home with the same brush and poultry paste we used; rechecks with calmer gingiva went up about 25% in 8 weeks, though cats often accept wipes better. If anyone’s building a script, the WSAVA guidance here helped: https://wsava.org/global-guidelines/dental-guidelines/.