286 resultados para Opioid Analgesia
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A técnica de analgesia multimodal, por meio da infusão contínua de fármacos, pode ser empregada para diminuir a incidência de sensibilização central durante a anestesia. Avaliaram-se as características cardiorrespiratórias, durante o procedimento de artroscopia de joelho, em cães anestesiados com isofluorano e monitorados por meio do índice biespectral, submetidos à infusão contínua de morfina ou fentanil, associada à lidocaína e cetamina. Utilizaram-se 16 cães adultos, machos ou fêmeas, os quais foram distribuídos aleatoriamente em dois grupos, denominados MLK - que recebeu morfina (3,3μg/kg/min), lidocaína (50μg/kg/min) e cetamina (10μg/kg/min) ou FLK - em que foi substituída a morfina pelo fentanil (0,03μg/kg/min). Os cães foram pré-tratados com levomepromazina (0,5mg/kg IV), induzidos à anestesia com propofol (5mg/kg) e mantidos com isofluorano, ajustando-se a concentração para obterem-se valores de índice biespectral entre 55 e 65. As mensurações da frequência cardíaca (FC), dos parâmetros eletrocardiográficos (ECG), das pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM), da tensão de dióxido de carbono expirado (EtCO2), da saturação de oxi-hemoglobina (SpO2), da frequência respiratória (FR) e da temperatura esofágica (T) iniciaram-se 30 minutos após a indução (M0) e continuaram após o início da infusão das soluções, em intervalos de 15 minutos (M15 a M75). Diferenças entre os grupos foram registradas para duração do complexo QRS (M60), para FC e T, entre M30 e M75, com MLK apresentando médias maiores que FLK, que registrou médias maiores que MLK para a SpO2 (M60), para os intervalos QT (M30 e M75) e RR (M0, M60 e M75). Concluiu-se que o emprego de morfina ou fentanil, associados à lidocaína e cetamina, promove efeitos semelhantes e não compromete as características avaliadas.
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Drugs commonly used in anesthesia practice may significantly alter the oxidative state of blood cells. This mechanism could contribute to the immune suppression that occurs transiently in the early postoperative period. Thus, we assessed the effects of continuous rate infusion (CRI) of propofol associated or not with tramadol on hematologic parameters in dogs. Eight adult mongrel dogs were anesthetized on 2 occasions, 15 d apart. Two groups were formed: control group (CG) and tramadol group (GT). Propofol was used for induction (10mg kg-1) followed by a CRI (0.7mg kg-1minute-1). The animals were positioned in lateral recumbency and mechanically ventilated with inspired oxygen fraction of 0.6. In TG, tramadol (2mg kg-1) followed by a CRI (0.5mg kg-1minute-1) was administered in dogs. In the CG the sodium chloride (NaCl) solution at 0.9% was administered followed by its CRI, in the same volume that was used in TG. The measurement was taken before anesthesia induction (Tbasal), 30 minutes after induction (T0) and then at 30-minute intervals (T30 to T60). Red blood cells, hematocrit, hemoblogin concentration and total leukocytes count decreased from T0 in both groups. In TG, lymphocytes count at Tbasal [1.86 (0.82) x103µl-1] was greater than at T0, T30 and T60 [0.96(0.50), 0.92(0.48) and 0.95(0.48) x103µl-1, respectively]. No significant differences were observed for platelets neutrophil, eosinophil, basophil and monocyte count. In dogs, propofol-anesthesia associated or not with tramadol promoted decrease in blood cell count and should be used with caution in immunossupressed patients.
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The hemodynamic effects of total intravenous anesthesia with propofol or propofol in combination with lidocaine were investigated in 12 dogs. In the P group (n=6), the dogs received a loading dose (LD) of 6mg kg-1 of propofol followed by a constant rate infusion (CRI) of 1.25mg kg-1 min-1. In the PL group (n=6), dogs received a LD of 6mg kg-1 of propofol and 1.5mg kg-1 of lidocaine followed by CRIs of 1.0mg kg-1 min-1 and 0.25mg kg-1 min-1 of propofol and lidocaine, respectively. The animals were instrumented for measurement of hemodynamic variables and bispectral index (BIS), recorded at 75, 90, 105 and 120 minutes during anesthesia. Cardiac index, stroke index, systolic, diastolic and mean arterial blood pressures were lower in the P group compared to the PL group (P<0.05). There were no significant differences between groups in heart rate, systemic vascular resistance index and BIS. Plasma concentrations of propofol were lower in group PL than in group P (medians of 5.7 to 6.1mg mL-1 in the P group versus 3.1 to 3.7mg mL-1 in the PL group). Measured lidocaine plasma concentrations (medians of 2.27 to 2.51mg mL-1) were in the range that result in analgesia and were below values that result in toxicity in dogs. The BIS values observed in the two groups of dogs were compatible with deep anesthesia (mean values of 43-46 and 45-49 in groups P and PL, respectively). Maintenance of deep anesthesia with lidocaine-propofol causes less cardiovascular depression than equipotent doses of propofol alone.
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Pós-graduação em Cirurgia Veterinária - FCAV
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Pós-graduação em Cirurgia Veterinária - FCAV
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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PURPOSE: To measure the change in the minimum alveolar concentration of isoflurane (EtISO) associated with epidural nalbuphine and the postoperative analgesic requirements in dogs after ovariohysterectomy.METHODS: Twenty four healthy female dogs were randomly assigned to receive saline or nalbuphine at 0.3 or 0.6 mg/kg (n=8 for each group) administered via lumbosacral epidural catheter introduced cranially into the epidural canal. Changes in heart and respiratory rates and arterial blood pressure during surgery were recorded along with the corresponding EtISO. Immediately after tracheal extubation, analgesia, sedation, heart rate, respiratory rate, and arterial blood pressure were measured at predetermined intervals and every 60 min thereafter until the first rescue analgesic.RESULTS: A significant decrease in EtISO was associated with epidural nalbuphine at 0.3 mg/kg (26.3%) and 0.6 mg/kg (38.4%) but not with saline in ovariohysterectomized dogs. In the postoperative period, VAS and Colorado analgesic scores were lower for the dogs that received the higher nalbuphine dose, which only required supplemental analgesia 10 h following its administration, compared with dogs that received the lower dose.CONCLUSION: Epidural nalbuphine significantly reduces the intra-operative isoflurane requirement and provides prolonged postoperative analgesia after ovariohysterectomy in dogs.
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Background: There are few studies reporting pain and postoperative analgesia associated with mastectomy in dogs. The aim of this study was to evaluate postoperative pain after unilateral mastectomy using two different surgical techniques in the dog.Findings: Twenty female dogs were assigned (n=10/group) to undergo unilateral mastectomy using either the combination of sharp and blunt dissection (SBD) or the modified SBD (mSBD) technique, in which the mammary chain is separated from the abdominal wall entirely by blunt (hand and finger) dissection except for a small area cranial to the first gland, in a prospective, randomized, clinical trial. All dogs were premedicated with intramuscular acepromazine (0.05 mg/kg) and morphine (0.3 mg/kg). Anesthesia was induced with intravenous ketamine (5 mg/kg) and diazepam (0.25 mg/kg), and maintained with isoflurane. Subcutaneous meloxicam (0.2 mg/kg) was administered before surgery. Postoperative pain was evaluated according to the University of Melbourne pain scale (UMPS) by an observer who was blinded to the surgical technique.. Rescue analgesia was provided by the administration of intramuscular morphine (0.5 mg/kg) if pain scores were > 14 according to the UMPS. Data were analyzed using t-tests and ANOVA (P>0.05). There were no significant differences between the groups for age, weight, extubation time, and duration of surgery and anesthesia (P>0.05). There were no significant differences for postoperative pain scores between groups. Rescue analgesia was required in one dog in each group.Conclusions: The two surgical techniques produced similar surgical times, incidence of perioperative complications and postoperative pain. Multimodal analgesia is recommended for treatment of postoperative pain in dogs undergoing unilateral mastectomy.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)