Overview
Updated: January 2026
Multimodal analgesia is recommended for all survival surgeries, which includes a combination of a local anesthetic, nonsteroidal anti-inflammatory drug (NSAID), and an opioid. The goal is to provide pre-emptive analgesia. Whenever possible, local anesthetics should be administered at the site of the incision as part of surgery preparation, and the first dose of NSAIDs administered immediately after or prior to anesthetic induction. To titrate for sedative effects, opioids such as buprenorphine should be administered 30-60 minutes prior to anesthetic induction when inhaled anesthetics (ie isoflurane) are used or during anesthetic recovery when injectable anesthetics (ie, ketamine combinations) are used.
NOTE: In all cases, analgesic regimen recommendations illustrate the standard veterinary practice and represent the expectation for minimum dosing frequency. Individual animals may require additional doses if post-operative monitoring indicates pain is still present after the last required dose.
Any deviations from these recommendations must be in consultation with a veterinarian and justified in the IACUC protocol. Consult a LARC veterinarian if adverse effects, inadequate analgesia, or unexpected clinical responses are observed.
For more invasive procedures in which severe pain is anticipated (thoracotomy, trauma, orthopedic procedures, etc) or NSAIDs are contraindicated consult with LARC veterinarians.
Standard Regimen
When mild to moderate pain is expecteed:
- Isoflurane 1-3% with 100% oxygen as the carrier gas
- Local anesthetic (lidocaine or bupivacaine) infiltrated at incision site prior to first incision
- Buprenorphine at the time of procedure, 4-8 hours after initial dose, and third dose the following morning OR extended-release buprenorphine at the time of surgery
- NSAID (meloxicam, carprofen or ketoprofen) at the time of procedure and 12-24 hours after initial dose
MICE
| Analgesia Agent | Dose Range (mg/kg) | Route | Frequency & Total Duration |
|---|---|---|---|
| Injectable Bupivacaine/Lidocaine (Choose one) | Bupivacaine: 0.25-0.5% bupivacaine, 1-2 local infiltrate; do not exceed 8 mg/kg total dose
| SC, Intra-incisional | Once at the time of surgery, given locally before making surgical incision. Bupivacaine onset 15-30 minutes; duration 4-6 hrs. Lidocaine onset 5-10 minutes; duration 1-2 hrs. |
| Buprenorphine (Choose one) | 0.05-0.1 (regular)
OR | SC or IP
| Once at the time of surgery and 4-8
|
| 3.25 (extended release) | SC only, undiluted
| Once at the time of surgery and 48-72 hours later, if needed.
| |
| NSAID (Choose one) | Meloxicam: 5-10
OR | SC only | Prior to or immediately after induction and again 12-24 hours after initial dose (2 doses). For accurate dosing, refer to dosing calculator on LARC website. |
RATS
| Analgesia Agent | Dose Range (mg/kg) | Route | Frequency & Total Duration |
|---|---|---|---|
| Injectable Bupivacaine/Lidocaine (Choose one) | Bupivacaine: 0.25-0.5% bupivacaine, 1-2 local infiltrate; do not exceed 8 mg/kg total dose OR Lidocaine: | SC, Intra-incisional | Once at the time of surgery, given locally before making surgical incision
Bupivacaine onset 15-30 minutes; duration 4-6 hrs.
Lidocaine onset 5-10 minutes; duration 1-2 hrs. |
| Buprenorphine (Choose one) | 0.01-0.05 (regular) OR | SC or IP
| Once at the time of surgery and 4-8
|
0.65 (extended release)
| SC only, undiluted
| Once at the time of surgery and 48-72 hours later, if needed.
| |
| NSAID (Choose one) | Meloxicam: 1-2 OR
| SC only | Prior to or immediately after induction and again 12-24 hours after initial dose (2 doses). |