Effect of bupivacaine liposome suspension administered as a cornual nerve block on indicators of pain and distress during and after cautery dehorning in dairy calves

Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, challenges often exist that complicate patient support and stabilization. Furthermore, burn wounds are complex and can present unique difficulties that require late intervention or life-long rehabilitation. In addition to improvements in patient stabilization and care, research in burn wound care has yielded advancements that will continue to improve functional recovery. This article reviews recent advancements in the care of burn patients with a focus on the pathophysiology and treatment of burn wounds.

Much has been learnt during the last 50 years about the causes of neonatal mortality and morbidity and about practical means for minimising them in newborn lambs, kids, bovine calves, deer calves, foals and piglets. The major causes of problems in these newborns are outlined briefly and include hypothermia due to excessive heat loss or to hypoxia-induced, starvation-induced or other forms of inhibited heat production. They also include maternal undernutrition, mismothering, infection and injury. The published literature reveals that the scientific investigations which clarified these causes and led to practical means for minimising the problems, involved iterative successions of self-reinforcing laboratory and field or clinical investigations conducted over many years. These studies focused largely on solutions to the problems, not on the suffering that the newborn might experience, so that an analysis of the associated welfare insults had not apparently been conducted until now. The present assessment focuses on potentially noxious subjective experiences the newborn may have. The account of the causes of neonatal mortality and morbidity outlined early in this review indicates that the key subjective experiences which require analysis in animal welfare terms are breathlessness, hypothermia, hunger, sickness and pain. Reference to documented responses of farm animals and, where appropriate, to human experience, suggests that breathlessness and hypothermia usually represent less severe neonatal welfare insults than do hunger, sickness and pain. Major science-based improvements in the management of pregnancy and birth have markedly reduced the overall amount of welfare compromise experienced by newborn farm animals and further improvements may be expected as knowledge is refined and extended in the future.

Dehorning and disbudding are routine painful procedures carried out on cattle to facilitate management. The pain caused by these procedures and its alleviation may be evaluated by monitoring behaviour and physiological responses, and by measuring their effects on weight gain. The cortisol response to cautery disbudding is significantly smaller than that to amputation dehorning which infers that the latter is more painful. Amputation dehorning stimulates a defined cortisol response with a rapid rise to a peak value within 30 min followed by a decline to a plateau which then declines to pre-treatment values after about 8 h. A cornual nerve blockade using lignocaine virtually eliminates the escape behaviour seen during disbudding and dehorning and reduces the plasma cortisol response to dehorning for about 2 h. Thereafter there is an increase in the plasma cortisol concentration, a delayed response, which lasts for about 6 h. A cornual nerve blockade, using lignocaine combined with cauterizing the wound caused by amputation dehorning, virtually eliminates the cortisol response as does combining a lignocaine blockade with the non-steroidal anti-inflammatory drug (NSAID) ketoprofen. When xylazine is combined with a cornual nerve blockade using lignocaine before dehorning, the cortisol response is virtually eliminated for about 3 h. When this regime is used before cautery disbudding and includes a NSAID given before and after disbudding the behaviour of calves so treated suggests that pain may be alleviated for 24 h. Cautery disbudding is preferable to amputation dehorning, but for optimal pain relief xylazine sedation, local anaesthesia and a NSAID should be used with both procedures.