Topical wound anaesthesia: efficacy to mitigate piglet castration pain

Effect of Topical Spray Containing Lidocaine on Piglet Behaviour Post castration

Previous studies examining the impact of topical lidocaine spray on postcastration pain behavior in piglets used scan sampling for the collection of behavior data. This methodology led to inconclusive results on the efficacy of topical lidocaine spray for pain relief. This study uses continuous coding to examine the effect of topical lidocaine on piglet behavior post castration. Castrated piglets received either no pain relief or topical lidocaine spray and are compared to gilts that were handled only. Postcastration piglet behavior was continuously coded for postural behaviors, social isolation, as well as nosing and playing. Behaviors in the castrated piglets differed from those that were handled only, but the piglets that received the spray did not exhibit significantly different behaviors from castrated pigs that received no spray. Play, exploratory behavior, and continuous behavioral observations proved to be sensitive modalities for detecting alterations in behavior postcastration and revealed that topical lidocaine spray does not provide effective pain mitigation for piglets undergoing castration and would thus not be recommended as a method for providing postcastration pain relief in piglets.

Role of Topical Anaesthesia in Pain Management of Farm Animals, a Changing Paradigm

Field evidence indicates that livestock producers are motivated by access to products that readily deliver pain management during husbandry interventions and, more recently, viral epidermal infectious diseases, including FMD. There has been impressive adoption in Australia of a farmer-applied spray-on topical anaesthetic wound formulation (TAF; Tri-Solfen®, Medical Ethics, Australia), initially for managing pain of the breech modification ‘mulesing’ procedure that reduces susceptibility of sheep to flystrike. Over 120 million lambs have now received pain relief and cattle producers have commenced using the TAF for a range of husbandry procedures. This product has demonstrated efficacy for surgical castration and tail docking of lambs, surgical castration and dehorning of calves, surgical castration of piglets, debridement of lesions of the hoof for lame cattle and, importantly, treatment of clinical FMD lesions, including decubitus ulcerations occurring from prolonged recumbency. Multimodal use of an NSAID for improved pain management is advocated, particularly meloxicam, available by prescription from veterinarians for injection and as an oral formulation (Ilium Buccalgesic®, Troy Laboratories, Australia), with current work assessing the potential for prolonged delivery in molasses blocks. Increased use of TAF with NSAIDs significantly reduces pain and suffering in livestock, with enhanced healing of FMD lesions, reduced viral loads from Orf infections in lambs and diminished necessity of ‘antibiotic cover’, assisting antimicrobial-resistance (AMR) stewardship.

Pharmacokinetic/pharmacodynamic modeling of ketoprofen and flunixin at piglet castration and tail-docking

This study performed population‐pharmacokinetic/pharmacodynamic (pop‐PK/PD) modeling of ketoprofen and flunixin in piglets undergoing routine castration and tail‐docking, utilizing previously published data. Six‐day‐old male piglets (8/group) received either ketoprofen (3.0 mg/kg) or flunixin (2.2 mg/kg) intramuscularly. Two hours post‐dose, piglets were castrated and tail docked. Inhibitory indirect response models were developed utilizing plasma cortisol or interstitial fluid prostaglandin E2 (PGE2) concentration data. Plasma IC50 for ketoprofen utilizing PGE2 as a biomarker was 1.2 μg/ml, and ED50 for was 5.83 mg/kg. The ED50 calculated using cortisol was 4.36 mg/kg; however, the IC50 was high, at 2.56 μg/ml. A large degree of inter‐individual variability (124.08%) was also associated with the cortisol IC50 following ketoprofen administration. IC50 for flunixin utilizing cortisol as a biomarker was 0.06 μg/ml, and ED50 was 0.51 mg/kg. The results show that the currently marketed doses of ketoprofen (3.0 mg/kg) and flunixin (2.2 mg/kg) correspond to drug responses of 33.97% (ketoprofen‐PGE2), 40.75% (ketoprofen‐cortisol), and 81.05% (flunixin‐cortisol) of the maximal possible responses. Given this information, flunixin may be the best NSAID to use in mitigating castration and tail‐docking pain at the current label dose.

Efficacy of Intra-Operative Topical Wound Anaesthesia to Mitigate Piglet Castration Pain-A Large, Multi-Centred Field Trial

Simple Summary

Piglet castration causes pain and stress to the animal. Although desperately needed, there are complexities developing safe and effective methods of pain alleviation applicable for on-farm use. Topical anaesthesia, instilled to the wound during surgery, is a newly evolving on-farm method to mitigate castration pain. In the current study, we investigated the use of Tri-Solfen^® (Animal Ethics Pty Ltd, Melbourne, Australia), a topical local anaesthetic and antiseptic formulation, instilled to the wound during the procedure, to alleviate subsequent castration-related pain experienced in piglets. We performed a large, blind, multi-centred trial comparing pain in piglets castrated with or without Tri-Solfen^®. Piglets treated with wound instillation of Tri-Solfen^®, 30 s prior to subsequent castration, showed significantly lower pain-induced motor and vocal responses during the procedure. Acute post-operative pain-related behaviours, evident in piglets in the first 30 min following castration, were also significantly reduced in treated piglets compared with untreated piglets. Using this method, Tri-Solfen^® provides an effective on-farm method to mitigate acute castration-related pain in young piglets.

Abstract

Piglet castration results in acute pain and stress to the animal. There is a critical need for effective on-farm methods of pain mitigation. Local anaesthesia using Tri-Solfen^® (Animal Ethics Pty Ltd., Melbourne, Australia), a topical local anaesthetic and antiseptic formulation instilled to the wound during surgery, is a newly evolving on-farm method to mitigate castration pain. To investigate the efficacy of Tri-Solfen^®, instilled to the wound during the procedure, to alleviate subsequent castration-related pain in neonatal piglets, we performed a large, negatively controlled, randomised field trial in two commercial pig farms in Europe. Piglets (173) were enrolled and randomised to undergo castration with or without Tri-Solfen^®, instilled to the wound immediately following skin incision. A 30 s wait period was then observed prior to completing castration. Efficacy was investigated by measuring pain-induced motor and vocal responses during the subsequent procedure and post-operative pain-related behaviour in treated versus untreated piglets. There was a significant reduction in nociceptive motor and vocal response during castration and in the post-operative pain-related behaviour response in Tri-Solfen^®-treated compared to untreated piglets, in the first 30 min following castration. Although not addressing pain of skin incision, Tri-Solfen^® is effective to mitigate subsequent acute castration-related pain in piglets under commercial production conditions.

Topical Application of Lidocaine and Bupivacaine to Disbudding Wounds in Dairy Calves: Safety, Toxicology and Wound Healing

Simple Summary

Disbudding is a common, but painful procedure performed on calves to prevent horn growth. Tri-Solfen^® is a combination local anaesthetic and antiseptic formulation which, applied topically to the disbudding wound, is reported to reduce calf pain. Applied in this manner, the local anaesthetics in Tri-Solfen^®, lidocaine and bupivacaine, are reported to be poorly absorbed, resulting in low risk of neurological or cardiotoxic effects. The potential impacts on other blood, urine and tissue parameters and on wound healing when used in this manner, and/or accidental overdose situations are unknown, however. We performed experiments investigating (i) the safety of Tri-Solfen^® (including overdose situations) and (ii) the impact of Tri-Solfen^® on disbudding wound healing under field conditions. No adverse health effects were observed in Tri-Solfen^®-treated animals, even those receiving 5× the recommended dose, with no clinically significant differences in measured parameters between placebo and Tri-Solfen^® groups. No negative impacts on wound healing were noted. Conversely, lower levels of bacterial wound colonisation were evident, and there was reduced incidence of abnormal wounds at days 11–12 in Tri-Solfen^®-treated animals.

Abstract

Tri-Solfen^® is a combination topical anaesthetic and antiseptic solution containing lidocaine, bupivacaine, adrenaline and cetrimide. Applied to wounds, it is reported to reduce the pain experienced by calves following thermocautery disbudding. While lidocaine and bupivacaine are widely used in medicine, conflicting data exist on the impact of these compounds when applied directly to the surgical wound. To investigate the safety of Tri-Solfen^® applied to thermocautery disbudding wounds of calves, experiments were performed to measure (i) the safety of Tri-Solfen^® (including in overdose situations); and (ii) the impact of Tri-Solfen^® application at recommended doses on disbudding wound healing under field conditions. Haematological, biochemical and urinalysis parameters did not show clinically significant differences between placebo and Tri-Solfen^® groups (1×, 3× and 5× dose). No adverse health impacts were reported. Histopathological analysis of wounds noted a reduction in bacterial colonies in Tri-Solfen^®-treated wounds. Under field conditions, no negative impacts on wound healing were noted. Conversely, there was reduced incidence of abnormal wounds, with an associated trend toward improved average daily gain at days 11–12 in Tri-Solfen^®-treated animals. These data are considered to support the safety of topical anaesthesia, as formulated in Tri-Solfen^®, to the thermocautery disbudding wound in calves.

Impact of tearing spermatic cords during castration in live and dead piglets and consequences on welfare

Background

Although the tearing of tissues during castration is forbidden in the EU, it is still routinely applied in many countries. The goal of this study was to evaluate vocalizations and movements of male piglets undergoing castration by applying different techniques and pain treatments based on scores under practical conditions (Trial 1, n = 50) and to investigate anatomical features after castration of dead piglets with different techniques (Trial 2, n = 28).

Results

In Trial 1, treatment groups did not significantly influence the duration of castration. Both the duration of vocalization and the scores for vocalizations and movements were lower in piglets castrated under general anesthesia (P < 0.05). Behavior scores in conscious piglets did not differ. The incision and extraction caused lower vocalizations and movements than the pulling and severing of spermatic cords (P < 0.01). Movements were more intense during tearing of the spermatic cords than during cutting at the first and second severing (P < 0.01). In both trials, the remains of spermatic cords protruded tendentially more often from castration wounds after severing by tearing (P < 0.09). In Trial 2, the minimum, mean and maximum lengths of the testicles and spermatic cords were extended when severing was realized by tearing (P < 0.01). The mean relative testicle weight of 1.05‰ in dead piglets castrated by tearing was larger than that in dead piglets castrated by cutting (0.91‰) (P < 0.05).

Conclusions

The trials uncovered significant differences between behavior expressed by piglets castrated by tearing or cutting, indicating a higher pain level in the tearing group. It was found that the castration technique tearing increased the amount of removed tissues and might cause intraabdominal damage to the remaining tissues and vessels in a yet unknown dimension. These findings should be considered for implementation and stricter enforcement of the ban on tearing for castration.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40813-021-00200-7.

Local Anesthesia in Piglets Undergoing Castration-A Comparative Study to Investigate the Analgesic Effects of Four Local Anesthetics Based on Defensive Behavior and Side Effects

Simple Summary

More than 80 million male piglets are castrated every year within the first week of life mostly without pain relief in the EU. Castration is performed to prevent boar taint, to minimize aggressive and sexual behavior associated with intact males and to gain a constant quality of meat. It is an important animal welfare issue to eliminate pain caused by castration. Local anesthesia, meaning the sole injection of a local anesthetic into the testicles and in the surrounding tissue of conscious piglets, prior to castration is a currently discussed method in Germany. Thus, it was the aim of the present study to investigate the effect of four local anesthetics (procaine, lidocaine, bupivacaine and mepivacaine) on pain relief during surgical castration in conscious piglets. To assess pain, defensive behavior of piglets undergoing injection and castration was evaluated. In addition, attention was paid to possible side effects. Considering healing, bleeding and weight gain no negative impacts were observed, but impairments of locomotor activity occurred. The results indicate that lidocaine and mepivacaine are able to achieve significant pain relief during the castration procedure, whereas procaine and bupivacaine only during the severing of the spermatic cord.

Abstract

The aim of the present study was to investigate the effect of four local anesthetics on pain relief during surgical castration under standardized conditions in conscious piglets. Therefore, 71 male piglets (three to seven days) were distributed into control groups (handling, castration without anesthesia or analgesia) and local anesthetic trial groups (procaine, lidocaine, bupivacaine, mepivacaine). Then, 20 min prior to castration, animals of the treatment groups, except piglets in the handling group, received an injection of a local anesthetic or sodium chloride of 0.5 mL intratesticularly and 0.5 mL subscrotally. During injection and castration, defensive behavior was evaluated. Locomotor activity, as well as postoperative bleeding, wound healing and average daily weight gain were assessed to detect side effects. The injection caused increased defensive movements, significantly in the bupivacaine group. Lidocaine and mepivacaine significantly reduced defensive movements during castration, and procaine and bupivacaine only during severing of the spermatic cord. Impairments of locomotor activity were found in piglets injected with lidocaine, bupivacaine or sodium chloride. Considering healing, bleeding and weight gain, no negative impacts were observed. In conclusion, lidocaine and mepivacaine were able to achieve significant pain relief during the castration procedure, whereas procaine and bupivacaine only during the severing of the spermatic cord. Moreover, the injection of bupivacaine seemed to be painful itself.

Optimal Methods of Documenting Analgesic Efficacy in Neonatal Piglets Undergoing Castration

Analgesic products for piglet castration are critically needed. This requires extensive animal experimentation such as to meet regulatory-required proof of efficacy. At present, there are no validated methods of assessing pain in neonatal piglets. This poses challenges for investigators to optimize trial design and to meet ethical obligations to minimize the number of animals needed. Pain in neonatal piglets may be subtle, transient, and/or variably expressed and, in the absence of validated methods, investigators must rely on using a range of biochemical, physiological and behavioural variables, many of which appear to have very low (or unknown) sensitivity or specificity for documenting pain, or pain-relieving effects. A previous systematic review of this subject was hampered by the high degree of variability in the literature base both in terms of methods used to assess pain and pain mitigation, as well as in outcomes reported. In this setting we provide a narrative review to assist in determining the optimal methods currently available to detect piglet pain during castration and methods to mitigate castration-induced pain. In overview, the optimal outcome variables identified are nociceptive motor and vocal response scores during castration and quantitative sensory-threshold response testing and pain-associated behaviour scores following castration.