Effects of dexmedetomidine on pulse pressure variation changes induced by hemorrhage followed by volume replacement in isoflurane-anesthetized dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Calvarial Autogenous Bone Graft for Maxillary Ridge and Sinus Reconstruction for Rehabilitation With Dental Implants

Autogenous bone grafting is the gold-standard technique for bone augmentation procedures prior to implant placement. If the amount of available intraoral donor bone is insufficient, it is necessary to harvest bone graft from extraoral sites, such as calvaria. Although this technique is well established, only a few case reports show the histological analysis of the grafted bone at the moment of implant placement. This article reports the case of a 48-year-old female patient with a critical atrophic maxillary ridge reconstructed using autogenous calvarial bone graft prior to implant placement, with clinical and histological evaluation. Bone was collected under general anesthesia from the parietal bone. The outer cortical originated the bone blocks, and the medullar bone layer between was collected to be used in the sinus augmentation procedure, together with 5 of the bone blocks triturated. Six months after bone augmentation, 8 implants were placed in the grafted area and 2 biopsies were retrieved (anterior and the posterior regions), allowing the visualization of the bone-remodeling process in the grafted areas. The patient had a stable recovery. Our results showed that although necrotic bone could still be seen in the outer layer of the grafted area, the interface between this necrotic bone and the already remodeled bone was consistent with biocompatibility. Two-year radiographic evaluation showed success of the grafts and the implants in supporting an esthetic and functionally stable prosthesis. Summarizing, calvarial bone grafts are a viable alternative for the attainment of adequate bone volume prior to implant placement.

Ocular ultrasonography and ultrasound biomicroscopy: applicability in clinical and ophthalmic surgery

With the advent of high frequency transducers, the use of ocular ultrasound has become widely used because it provides definitions of major ocular structures. This diagnostic tool is useful in the evaluation of ophthalmic injuries, and also used for qualitative and quantitative evaluation of intraocular and orbital lesions. It is a noninvasive, safe and fast, easy to use and can be performed in an awake animal. The ocular ultrasonography is indicated in cases of ocular opacity, when the ophthalmic examination cannot be done, and in eyes with ocular trauma or suspected orbital disease. Ultrasound biomicroscopy (UBM) is a diagnostic tool with high cost and sedation or general anesthesia is necessary, but has the advantage of evaluating structures poorly defined or visualized in the anterior segment of the eye. Therefore, this paper aims to show the importance of ocular ultrasonography and UBM to veterinary practitioners, and to demonstrate its advantages and indications in ophthalmic routine.

Cardiovascular and respiratory evaluation during cervical myelography using ioversol in dogs

The objective of this study was to evaluate cardiovascular and respiratory effects associated with neck flexion, subarachnoid puncture, cerebrospinal fluid drainage and the subarachnoid infusion of ioversol (320mgl/mL) in dogs under isoflurane general anesthesia. The dogs received infusion of: autologous cerebrospinal fluid at 38 degrees C (GC - control group); ioversol 0.3mL/ Kg at 25 degrees C (GI25) and heated to 38 degrees C (GI38). Heart rate, systolic and diastolic arterial pressure, respiratory rate, oxyhemoglobin saturation and electrocardiography readings were recorded. The results showed that cervical myelography with ioversol 320mgl/mL at 0.3mL/Kg (25 C-degrees and 38C degrees) did not significantly alter recorded parameters, except for an elevation in arterial pressure.

Two-stage rumenostomy in buffaloes

Background: Rumenostomy may be performed for therapeutic and digestibility research purposes in bovines, small ruminants and camelids. Several studies requires romenostomy in buffaloes in order to sample ruminal content for laboratorial assays. However, complications and outcome of rumenostomy was poorly studied in buffaloes. Therefore, the aim of the current study was to describe a two-stage rumenostomy technique in buffaloes, focused on intra and post-operative period.Materials, Methods & Results: Nine Murrah buffaloes were submitted to a 36-h and 12-h of food and water fastening. The animals were given acepromazine and maintained in standing position. Flank local anesthesia was carried out. A circular skin incision was carried out in the center of the left flank, followed by divulsion of the external and internal obliques and transversus abdominus muscles, and incision of the peritoneum. Subsequently, a segment of the dorsal aspect of the rumen was grasped and pulled through the flank incision. The rumen was attached to the peritoneum and skin incision margins in four points (dorsal, ventral, cranial and caudal). Additional simple interrupted sutures attaching the rumen serosa to the skin were applied subsequently. Four additional interrupted horizontal mattress sutures were applied equidistantly, taking bites only in the skin and rumen serosa. Following 12 h, the second stage was carried out. The buffaloes were prepared and restrained as performed for the first stage. A circular flap was excised from the exteriorized rumen and the silicone romenostomy cannula was placed. Clinical parameters, postoperative recovery, weight and behavioral pain scale were assessed. Positioning and anesthesia regimen were adequate for the achievement of the procedure. However, two animals fell in the restraint chute during the first surgical stage. Mild ischemia of the exteriorized rumen segment was observed on the second surgical stage, which resulted in less hemorrhage and enhanced cannula positioning. Complete cicatrization and permanent adhesion of the rumen to the skin were achieved. No ruminal leakage to the abdominal cavity occurred. No signs of pain were reported. There were few cases of laxity of the romenostomy opening leading to drop of cannula, myiasis on the margin of the stoma site and few cases of mild ruminal content leakage on the long-term assessment.Discussion: Restraint in standing position was considered adequate, although lateral recumbence constitutes another option. However, higher risk of contamination and technical difficulties in placing the cannulas are expected if lateral recumbence is considered. In other trials using acepromazine, no accidental recumbence occurred. Xylazine was also indicated for chemical restraint of buffaloes. It is known that flexible cannulas provide better anatomic adjustment and adaptation as well as being effective for sampling ruminal content, as seen in the current study. Ruminal leakage is one of the most frequent complications of romenostomy, which may affect animal's welfare. The animals in the current study presented no variations on the body score, even though on those presenting cannula loosening or ruminal content leakage. Moreover, no significant changes of the ruminal content parameters were noticed. Myiasis was also reported following ruminal surgical interventions, which were mainly attributed to extensive breeding. Loss of the cannula, subcutaneous emphysema and suture dehiscence are common complications of romenostomy. Nonetheless, none of those complications were found on the current study. Thus, romenostomy was feasible and efficient for sampling and performing assays of the ruminal content in buffaloes.

Avaliação da eficácia da analgesia com acupuntura pela análise imuno-histoquimica da expressão de proteína C-Fos: estudo em modelo experimental de dor aguda em ratos

The behavior and experience of pain are characterized by alertness and anxiety, which disappear soon after the healing process begins. Based on this area, the present study aimed to quantify the expression of c-fos in segments of the brain of rats after surgical stimulation in one rear hind paw (analgesia), using anesthesia with sodium thiopental and practices of acupuncture pre and post operative. The animals were stimulated with intraperitoneal injections of solution (NaCl) 0.2% (2ml), and divided into three groups, control, preoperative and postoperative. Each treatment was divided in manual acupuncture (AM) and electroacupuncture (EA). The animals were randomly distributed in each group. The c-fos expression was quantitated using immunohistochemistry for all situations. The results showed a great efficiency of all treatment compared to the control group (p <0.001), thus reenforcing data in the literature on the potential of acupuncture analgesia. There were no statistical differences among the different treatments, although there was a trend of EA being more efficient than AM

Considerações anestésicas para realização da cirurgia de facoemulsificação em cães

Cataract is the leading cause of blindness in dogs. It is defined as an opacity in the lens and is independent of resulting visual deficit. Although there are a growing number of studies related to drug therapy of cataract, the treatment is still considered exclusively surgical. Among the techniques used to remove cataract, phacoemulsification is the best performer. Anesthesia in intraocular surgery has several peculiarities, which are essential to successfully conduct phacoemulsification in dogs. In these patients, a safe and effective anesthesia requires the maintenance of intraocular pressure close to normal, preventing the activation of the oculo-cardiac reflex and complete immobilization of the eye. The appropriate conditions for such surgical procedures can be established through the use of drugs from different pharmacological groups for premedication, induction and maintenance of anesthesia, making a balanced anesthesia. This work was compiled from a careful review of the literature on anesthesia in cataract surgery. Considerations on the pre-medication, induction and maintenance of anesthesia are discussed, aiming to contribute to the phacoemulsification becomes more safe and suitable for the anesthesiologist and the surgeon as well as comfortable for dogs undergoing surgery

Comparando a eficácia da manta térmica com método de aquecimento passivo na prevenção de hipotermia

Hypothermia is a common phenomenon in the perioperative period, and it affects 60 to 90% of patients submitted to anesthetic-surgical procedures. In order to minimize its incidence, warming methods are used. Such methods can be passive, such as orthopedic cotton, sheets and blankets, or active, such as warm-air blankets and thermal mattresses. In this scenario, the present study aimed at comparing two warming methods used in the intraoperative period. Patients submitted to abdominal surgery in the specialties of gynecology and gastric surgery from August to September 2010 were included in the study. After randomization, they were divided into two groups: one using a thermal blanket (group I) and one using orthopedic cotton (group II). At last, 9 patients were included. The variables for each question were considered according to occurrence frequency. Comparison between groups was performed by Student’s t test. With the purpose to analyze whether there was an association, the chi-square test or Fisher’s Exact test was used. Whenever it was applicable for multiple comparisons, Tukey’s test was utilized; p values < 0.05 were considered to be statistically significant for analysis. The sample comprised 6 males and 3 females submitted to gynecological and gastric surgeries. Their mean age was 48 years for group I and 46.2 years for group II. A predominance of general anesthesia was observed. The time of permanence in the operating room ranged from 80 to 360 minutes. With regard to warming parenteral solutions, the procedure was performed on 5 patients, and infusion of warm solution into the abdominal cavity was performed on 50% of the sample. Concerning the warming method used, 5 patients used a thermal blanket. In view of the results presented, it was not possible to conclude which warming method should be used due to sample size

Mensuração e análise do ph salivar em pacientes com hiperidrose submetidos a cirurgia de simpatectomia videotoracoscópica

The study was performed to verify if there are changes in salivary pH in patients with hyperhidrosis who were treated by Videothoracoscopic Sympathectomy. Twelve patients underwent sympathectomy with clamping the sympathetic chain along the vertebrae T2, T3 and T4, under inhalation and intravenous general anesthesia and with drainage of pneumothorax through probe N° 16. These patients had their saliva collected 1 day before and 7 days after surgery for measurement of pH by the colorimetric method with indicator paper. All patients showed no sign or symptom of hyperhidrosis in the immediate postoperative period, which demonstrates the success of sympathetic denervation on these levels. No patient had compensatory sweating and there was no post-operatively surgical complication. No drug or substance has been administered to patients for the study. The pH results obtained were analyzed using test ´´t´´ Student. Although the average pH in samples obtained after surgery was lower than the preoperative, the test revealed no statistically significant difference (p = 0.181). It is concluded that sympathectomy, an excellent therapeutic and definitive method for hyperhidrosis, does not alter the salivary pH, and so, did not influence the cariogenic process

Avaliação da qualidade da atenção ao parto nos colegiados de gestão regional Cuesta Botucatu e Vale do Jurumirim

The humanization of childbirth implies the understanding of this event as an important experience, and requires the redefinition of human relationships from the review of the assistance project, the understanding of pregnant women condition and human rights. To evaluate child birth assistance using a score that was developed by Botucatu Cuesta Regional Management and Jurumirim Valley Collegiates. This is an epidemiological, descriptive study that is inserted in the field of evaluation of services, programs or health projects. The data has been obtained by direct observation of deliveries, emphasizing the humane care. Results: Approximately one third of the women gave birth in a tertiary hospital (34.1%) and it was their first babies (33%).24.8% of the women received prenatal care in high-risk services. 67.1% of the births were normal, and 84.7% had no companions in the delivery room. In 47.1% of the cases the delivery was performed by obstetrician who used anesthesia in 44.7% and episiotomy in 48.2% of the deliveries. More than half of the newborns were attended by the pediatrician in the delivery room and had a delivery graph completed. Although the present study shows that 67.1% of the births were normal, caesarean rate can be considered excessive, as the WHO points out that c-sections above 15% are unlikely to be justifiable. It is important to emphasize that the Ministry of Health has to have a commitment with all women to promote safe motherhood, even in cases when the pregnancy involves a risk for both the mother and the fetus. It is noteworthy that the created score allowed us to assess variables related to the humanization of childbirth and only average and quite similar situations among the three services were evidenced. We hope that with this study, managers and professionals that work in this area can be subsidized in order to offer effective humane assistance and quality service in the delivery

Associações neuroleptoanalgésicas em equinos

The equine anesthesia is proven to be a high risk procedure, for both patient and anesthetist, compared to other animal species. In these conditions, a good anesthetic protocol that can deliver sedation, making access and manipulation easier, analgesia fair enough to realize cirurgical procedures, and minimal physiologic changes would be ideal. Since there aren’t any drugs suporting all these qualities, the Neuroleptoanalgesic Associations show themselves as a valuable technique to provide anesthetic quality and safety, possibly diminishing our drug of choice’s doses, therefore offering less fisiological changes and easier monetary access in some cases. This paper objective was to list all these associations found in literature, evaluating their advantages and practical applications

Alterações hepáticas em cães intoxicados experimentalmente por sementes de Crotalaria spectabilis

Pós-graduação em Medicina Veterinária - FCAV

Efeitos da infusão contínua de tiopental ou propofol em coelhos mantidos em respiração espontânea

Pós-graduação em Cirurgia Veterinária - FCAV

Efeitos do metotrexate subaracnoideo sobre a medula espinal e as meninges de coelhos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da pressão liquórica em pacientes obstétricas submetidas à anestesia subaracnoidea que apresentaram cefaleia pós-punção dural

Pós-graduação em Anestesiologia - FMB