Acid-base and biochemical stabilization and quality of recovery in male cats with urethral obstruction and anesthetized with propofol or a combination of ketamine and diazepam

This study compared acid-base and biochemical changes and quality of recovery in male cats with experimentally induced urethral obstruction and anesthetized with either propofol or a combination of ketamine and diazepam for urethral catheterization. Ten male cats with urethral obstruction were enrolled for urethral catheterization and anesthetized with either ketamine-diazepam (KD) or propofol (P). Lactated Ringer's solution was administered by intravenous (IV) beginning 15 min before and continuing for 48 h after relief of urethral obstruction. Quality of recovery and time to standing were evaluated. The urethral catheter was maintained to measure urinary output. Hematocrit (Hct), total plasma protein (TPP), albumin, total protein (TP), blood urea nitrogen (BUN), creatinine, pH, bicarbonate (HCO3-), chloride, base excess, anion gap, sodium, potassium, and partial pressure of carbon dioxide in mixed venous blood (pvCO(2)) were measured before urethral obstruction, at start of fluid therapy (0 h), and at subsequent intervals. The quality of recovery and time to standing were respectively 4 and 75 min in the KD group and 5 and 16 min in the P group. The blood urea nitrogen values were increased at 0, 2, and 8 h in both groups. Serum creatinine increased at 0 and 2 h in cats administered KD and at 0, 2, and 8 h in cats receiving P, although the values were above the reference range in both groups until 8 h. Acidosis occurred for up to 2 h in both groups. Acid-base and biochemical stabilization were similar in cats anesthetized with propofol or with ketamine-diazepam. Cats that received propofol recovered much faster, but the ketamine-diazepam combination was shown to be more advantageous when treating uncooperative cats as it can be administered by intramuscular (IM) injection.

Caixa lúdica para idosos: processo de construção como procedimento clínico e sua contribuição na qualidade do vínculo

Ninguém envelhece da mesma maneira e as alterações causadas pelo envelhecimento desenvolvem-se num ritmo diferente para cada pessoa. O objetivo deste trabalho é apresentar a utilização da Caixa Lúdica para idosos, seu emprego e as possibilidades de influência na qualidade do vínculo. A caixa lúdica para idosos facilitou o vínculo emocional no atendimento clínico, permitiu a melhor socialização de pessoas idosas institucionalizadas, fez emergir questões relacionadas a angústias básicas, desejos inconscientes e principais mecanismos de defesa. Essa técnica permite a manifestação das múltiplas expressões do mundo interno, importante na compreensão e manejo e na melhoria das condições de saúde e bem estar do idoso, tal como um instrumento preventivo e de fácil aplicação para melhorar a qualidade de vida dos idosos.