Pneumocephalus and suppurative meningoencephalitis in a dog after craniofacial trauma

Background: Pneumocephalus is characterized by the presence of gas in the intracranial compartment, and it can be developed by trauma, craniofacial surgery or spontaneously. Clinical signs start within days or months after the injury and vary according to the site of involvement. Computed tomography is the ideal diagnostic tool, however skull radiography can also be used. Treatment varies according to the severity of the case, and it can be conservative or associated with surgical intervention in the most severe cases. The purpose of this report is to describe the case of a dog that developed pneumocephalus and suppurative meningoencephalitis after head trauma caused by a bite from another dog. Case: A 2-month-old bitch, mixed breed, with 3.2 kg, was referred to the Veterinary Hospital because it had been bitten on the head by another dog. Shortly after the incident, the animal showed no clinical signs. However, 2 days later, the bitch became depressed and in persistent lateral decubitus. A lesion with a crust of approximately 0.5 cm was found close to the occipital region, with bone irregularity on palpation. The animal was in lateral decubitus with muscular hypotonia, bilateral mydriasis unresponsive to light and stupor. Radiographic images showed parietal fracture and pneumocephalus. Based on the findings of physical and laboratorial exams, diagnosis of suppurative meningoencephalitis and pneumocephalus secondary to craniofacial trauma was established. Empirical broad-spectrum antimicrobial therapy was started in addition to mannitol, corticoids, and analgesics. The animal was referred for surgical debridement by trepanation, when samples were collected to bacterial culture, which was negative. Despites the care, the animal died 14 h after the surgical procedure. Histopathological examination of the frontal cortex was performed, being the histological changes compatible with suppurative meningoencephalitis. Discussion: Dog bites on the head and neck are particularly severe, and can create intracranial bleeding, disfigurement of the face, damage to peripheral structures or cranial fractures. In this report, through radiographic images, it was found that the patient had an intracerebral aerocele, since there was presence of gas in the intracranial compartment. This alteration should always be considered in animals with neurological alterations and a history of craniofacial trauma. The main neurological changes observed in the reported case were unresponsive to mydriasis and altered mental status 2 days after the trauma, and this delay in the onset of clinical signs is frequently reported in cases of pneumocephalus. Neutrophilia and leukocytosis observed can be justified by the suppurative meningoencephalitis, confirmed by the histopathological exam. Antimicrobial therapy should be started as soon as possible, and the choice must be based on their capacity to cross the blood-brain barrier and the broad spectrum. The administration of antibiotics before collecting the material for bacterial culture may explain the negative result of this test, so that it is not possible to determine whether the intracranial gas observed on the radiograph may have developed from the trauma or because of gas-producing bacteria. Head trauma can induce suppurative meningoencephalitis and pneumocephalus even in the absence of perforating wounds at the time of the consultation. The neurological signs can start days after the trauma. Besides the clinical and surgical treatments, the prognosis of any bacterial infection of the central nervous system is poor.

Analgesia pós-operatória com Fentanil transdérmico ou Metadona intramuscular em cães submetidos à hemilaminectomia toracolombar / Postoperative analgesia with transdermal Fentanyl or intramuscular Methadone in dogs submitted to thoracolumbar hemilaminectomy

Background: Postoperative care after thoracolumbar hemilaminectomy in dogs generally includes rest, physical therapy,and analgesics such as opioids. Currently, there is no established standard for the management of postoperative pain inpatients undergoing hemilaminectomy. Ideally, an analgesic protocol should provide adequate pain relief with limited sedation, low adverse effects, and postoperative patient comfort. Therefore, this study aimed to evaluate postoperative analgesiausing transdermal fentanyl or intramuscular methadone in dogs undergoing thoracolumbar hemilaminectomy associatedwith intervertebral disc fenestration (HT) for the treatment of intervertebral disc extrusion (IVDE).Materials, Methods & Results: Eight dogs from the Department of Neurology and Neurosurgery of a Veterinary TeachingHospital, submitted to HT for the treatment of IVDE, were included. The dogs were randomly distributed into 2 groups ofequal numbers, namely the transdermal fentanyl (FT) group and the intramuscular methadone (IM) group. At the end ofthe surgical procedure, a fentanyl adhesive patch was applied to the animals in the FT group, which remained there for 72h. In the IM group, analgesia was induced by intramuscular administration of methadone at intervals of 6 h until 72 h aftersurgery. The animals were evaluated using the short form of the Glasgow Composite Measure Pains Scale (CMPS-SF).Evaluations of physiological parameters, side effects, and pain were performed by 2 assessors who had experience usingthe pain scale and were blinded to the analgesic protocol. Pain evaluations were performed every 2 h (from T4) until 24h after the surgical procedure. Evaluations were performed every 4 h from 24 h to 48 h after the surgical procedure and...

Microsurgery versus embolization: different risk factors for short- and long- term outcomes of patients with ruptured aneurysms

Purpose: To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods: Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS). Results: Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group. Conclusions: Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion

ABSTRACT: The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.

RESUMO: O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.

Postoperative analgesic effects of Reiki therapy in bitches undergoing ovariohysterectomy / Efeito analgésico pós-operatório da terapia Reiki em cadelas submetidas a ovariohisterectomia

ABSTRACT: This study aimed to evaluate the effects of Reiki therapy on postoperative pain in bitches undergoing elective minimally invasive ovariohysterectomy (OVH). Thirty bitches were randomly assigned to three groups: Control, Placebo, or Reiki. All dogs received methadone as preanesthetic medication (PAM), meloxicam in the preoperative period, propofol for anesthetic induction, and isoflurane for anesthetic maintenance. Immediately after OVH, the dogs in the Reiki were submitted to a single session of Reiki therapy, dogs in the Placebo received simulated Reiki therapy from a non-therapist, and dogs in the Control received no treatment. All dogs were evaluated for pain using short-form Glasgow composite measure pain scale (CMPS-SF) and visual analog scale (VAS) before (M0) and 2 (M2), 4 (M4), 8 (M8), 12 (M12), and 24 hours (M24) after administration of PAM. Comparing the CMPS-SF scores between the groups, at M2 Reiki scores were lower than those of the Placebo and at M4 those in the Reiki were lower than those of the Control or Placebo groups. Comparing the VAS scores, at M4 and M8, Reiki scores were lower than those of the Control or Placebo groups. Additional analgesia (morphine 0.2 mg.kg-1 intramuscularly) was administered to three bitches in Control and to four bitches of the Placebo. Reiki did not require additional opioid analgesia in the postoperative period. It was concluded that Reiki therapy provided analgesic effect and contributed to improve postoperative comfort of bitches submitted to elective OVH.

RESUMO: Este estudo teve o objetivo de avaliar os efeitos da terapia Reiki na dor do período pós-operatório de cadelas submetidas à ovariohisterectomia (OVH) eletiva pelo método minimamente invasivo com gancho. Para isso, foram utilizadas 30 cadelas alocadas aleatoriamente em três grupos experimentais: Controle, Placebo e Reiki. Todos os animais receberam metadona como medicação pré-anestésica (MPA), meloxicam, propofol na indução anestésica e isofluorano na manutenção anestésica. Imediatamente após a OVH, os animais do Reiki foram submetidos a uma única sessão de Reiki, os animais do Placebo receberam uma simulação da terapia Reiki por um indivíduo não terapeuta e os animais do Controle não receberam nenhum tratamento. Os animais foram avaliados por meio da forma curta da escala de dor de Glasgow (CMPS-SF) e da escala visual analógica (EVA) antes da administração da MPA (M0) e 2h (M2), 4h (M4), 8h (M8), 12h (M12) e 24h (M24) após a MPA. Comparando-se os valores obtidos pela CMPS-SF, em M2, os valores do Reiki foram menores que do Placebo e, em M4, os valores do Reiki foram menores que do Controle e do Placebo. Observando-se os dados obtidos com a EVA, em M4 e M8, os valores do Reiki foram menores que do Controle e do Placebo. Foi administrada analgesia adicional (0,2 mg.kg-1 de morfina por via intramuscular) em três animais do Controle e em quatro animais do Placebo. Os animais do Reiki não necessitaram de analgesia adicional no período pós-operatório. Concluiu-se que a terapia Reiki contribuiu com a analgesia e o conforto pós-operatório de cadelas submetidas à OVH eletiva.

Postoperative analgesic effects of Reiki therapy in bitches undergoing ovariohysterectomy / Efeito analgésico pós-operatório da terapia Reiki em cadelas submetidas a ovariohisterectomia

This study aimed to evaluate the effects of Reiki therapy on postoperative pain in bitches undergoing elective minimally invasive ovariohysterectomy (OVH). Thirty bitches were randomly assigned to three groups: Control, Placebo, or Reiki. All dogs received methadone as preanesthetic medication (PAM), meloxicam in the preoperative period, propofol for anesthetic induction, and isoflurane for anesthetic maintenance. Immediately after OVH, the dogs in the Reiki were submitted to a single session of Reiki therapy, dogs in the Placebo received simulated Reiki therapy from a non-therapist, and dogs in the Control received no treatment. All dogs were evaluated for pain using short-form Glasgow composite measure pain scale (CMPS-SF) and visual analog scale (VAS) before (M0) and 2 (M2), 4 (M4), 8 (M8), 12 (M12), and 24 hours (M24) after administration of PAM. Comparing the CMPS-SF scores between the groups, at M2 Reiki scores were lower than those of the Placebo and at M4 those in the Reiki were lower than those of the Control or Placebo groups. Comparing the VAS scores, at M4 and M8, Reiki scores were lower than those of the Control or Placebo groups. Additional analgesia (morphine 0.2 mg.kg-1 intramuscularly) was administered to three bitches in Control and to four bitches of the Placebo. Reiki did not require additional opioid analgesia in the postoperative period. It was concluded that Reiki therapy provided analgesic effect and contributed to improve postoperative comfort of bitches submitted to elective OVH.

Este estudo teve o objetivo de avaliar os efeitos da terapia Reiki na dor do período pós-operatório de cadelas submetidas à ovariohisterectomia (OVH) eletiva pelo método minimamente invasivo com gancho. Para isso, foram utilizadas 30 cadelas alocadas aleatoriamente em três grupos experimentais: Controle, Placebo e Reiki. Todos os animais receberam metadona como medicação pré-anestésica (MPA), meloxicam, propofol na indução anestésica e isofluorano na manutenção anestésica. Imediatamente após a OVH, os animais do Reiki foram submetidos a uma única sessão de Reiki, os animais do Placebo receberam uma simulação da terapia Reiki por um indivíduo não terapeuta e os animais do Controle não receberam nenhum tratamento. Os animais foram avaliados por meio da forma curta da escala de dor de Glasgow (CMPS-SF) e da escala visual analógica (EVA) antes da administração da MPA (M0) e 2h (M2), 4h (M4), 8h (M8), 12h (M12) e 24h (M24) após a MPA. Comparando-se os valores obtidos pela CMPS-SF, em M2, os valores do Reiki foram menores que do Placebo e, em M4, os valores do Reiki foram menores que do Controle e do Placebo. Observando-se os dados obtidos com a EVA, em M4 e M8, os valores do Reiki foram menores que do Controle e do Placebo. Foi administrada analgesia adicional (0,2 mg.kg-1 de morfina por via intramuscular) em três animais do Controle e em quatro animais do Placebo. Os animais do Reiki não necessitaram de analgesia adicional no período pós-operatório. Concluiu-se que a terapia Reiki contribuiu com a analgesia e o conforto pós-operatório de cadelas submetidas à OVH eletiva.

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

Postoperative analgesic effects of Reiki therapy in bitches undergoing ovariohysterectomy / Efeito analgésico pós-operatório da terapia Reiki em cadelas submetidas a ovariohisterectomia

This study aimed to evaluate the effects of Reiki therapy on postoperative pain in bitches undergoing elective minimally invasive ovariohysterectomy (OVH). Thirty bitches were randomly assigned to three groups: Control, Placebo, or Reiki. All dogs received methadone as preanesthetic medication (PAM), meloxicam in the preoperative period, propofol for anesthetic induction, and isoflurane for anesthetic maintenance. Immediately after OVH, the dogs in the Reiki were submitted to a single session of Reiki therapy, dogs in the Placebo received simulated Reiki therapy from a non-therapist, and dogs in the Control received no treatment. All dogs were evaluated for pain using short-form Glasgow composite measure pain scale (CMPS-SF) and visual analog scale (VAS) before (M0) and 2 (M2), 4 (M4), 8 (M8), 12 (M12), and 24 hours (M24) after administration of PAM. Comparing the CMPS-SF scores between the groups, at M2 Reiki scores were lower than those of the Placebo and at M4 those in the Reiki were lower than those of the Control or Placebo groups. Comparing the VAS scores, at M4 and M8, Reiki scores were lower than those of the Control or Placebo groups. Additional analgesia (morphine 0.2 mg.kg-1 intramuscularly) was administered to three bitches in Control and to four bitches of the Placebo. Reiki did not require additional opioid analgesia in the postoperative period. It was concluded that Reiki therapy provided analgesic effect and contributed to improve postoperative comfort of bitches submitted to elective OVH.(AU)

Este estudo teve o objetivo de avaliar os efeitos da terapia Reiki na dor do período pós-operatório de cadelas submetidas à ovariohisterectomia (OVH) eletiva pelo método minimamente invasivo com gancho. Para isso, foram utilizadas 30 cadelas alocadas aleatoriamente em três grupos experimentais: Controle, Placebo e Reiki. Todos os animais receberam metadona como medicação pré-anestésica (MPA), meloxicam, propofol na indução anestésica e isofluorano na manutenção anestésica. Imediatamente após a OVH, os animais do Reiki foram submetidos a uma única sessão de Reiki, os animais do Placebo receberam uma simulação da terapia Reiki por um indivíduo não terapeuta e os animais do Controle não receberam nenhum tratamento. Os animais foram avaliados por meio da forma curta da escala de dor de Glasgow (CMPS-SF) e da escala visual analógica (EVA) antes da administração da MPA (M0) e 2h (M2), 4h (M4), 8h (M8), 12h (M12) e 24h (M24) após a MPA. Comparando-se os valores obtidos pela CMPS-SF, em M2, os valores do Reiki foram menores que do Placebo e, em M4, os valores do Reiki foram menores que do Controle e do Placebo. Observando-se os dados obtidos com a EVA, em M4 e M8, os valores do Reiki foram menores que do Controle e do Placebo. Foi administrada analgesia adicional (0,2 mg.kg-1 de morfina por via intramuscular) em três animais do Controle e em quatro animais do Placebo. Os animais do Reiki não necessitaram de analgesia adicional no período pós-operatório. Concluiu-se que a terapia Reiki contribuiu com a analgesia e o conforto pós-operatório de cadelas submetidas à OVH eletiva.(AU)

The need for opioid in the postoperative analgesia of dogs undergoing hemilaminectomy due to intervertebral disc extrusion / A necessidade de opioide na analgesia pós-operatória de cães submetidos à hemilaminectomia devido à extrusão do disco intervertebral

The aim of this study was to evaluate the postoperative analgesic effect of protocols with and without the opioid methadone in dogs with intervertebral disc extrusion undergoing decompressive surgery. Sixteen paraplegic dogs with preserved nociception underwent hemilaminectomy/disc fenestration and were randomly assigned to two groups. The analgesic protocol consisted of methadone, meloxicam and dipyrone in Group I (G1), and meloxicam and dipyrone in Group II (G2). The animals were blindly assessed by two observers, using the visual analogue scale (VAS) and the short-form Glasgow Composite Measure Pain Scale (CMPS-SF). Assessments occurred every 2 hours during first 24 hours post-surgery, and every 4 hours afterwards. There was no statistical difference among groups regarding pain scores or analgesic rescues. Both analgesic protocols provided analgesia in the initial 48 hours postoperatively, demonstrating that opioids are not necessary in the postoperative period of dogs undergoing hemilaminectomy and disc fenestration.(AU)

O objetivo deste estudo foi avaliar a analgesia pós-operatória de protocolos com e sem o opioide metadona em cães com extrusão de disco intervertebral submetidos à descompressão cirúrgica. Dezesseis cães paraplégicos com presença de nocicepção foram submetidos à hemilaminectomia/fenestração de disco e distribuídos aleatoriamente em dois grupos. No Grupo I (G1), o protocolo analgésico consistiu em metadona, meloxicam e dipirona e, no Grupo II (G2), por meloxicam e dipirona. Os pacientes foram avaliados de maneira cega por dois avaliadores, com base na escala visual analógica (EVA) e na escala simplificada composta de dor de Glasgow (CMPS-SF). As avaliações ocorreram a cada 2 horas durante as primeiras 24 horas de pós-operatório e, por mais 24 horas, a cada 4 horas. Não houve diferença estatística entre os grupos avaliados em relação à escores de dor e nem a necessidade de resgate analgésico. Ambos os protocolos promoveram analgesia nas 48 horas iniciais de pós-operatório, demonstrando não haver a necessidade do uso de opioide em cães submetidos à hemilaminectomia e fenestração de disco.(AU)

Avaliação pós-operatória da analgesia promovida pelo uso da dexmedetomidina isolada e associada à morfina em cadelas submetidas à ovariohisterectomia / Postoperative evaluation of analgesia promoted by the use of dexmedetomidine alone and associated with morphine as an intramuscular pre-anesthetic medication in bitches submitted for ovariohysterectomy

Objetivou-se avaliar a eficácia analgésica pós-operatória da dexmedetomidina isolada e associada à morfina em pacientes submetidas à anestesia geral inalatória com isoflurano e submetidas à ovariohisterectomia eletiva (OH). Vinte cadelas saudáveis foram selecionadas a partir de exames físico e laboratoriais. Previamente ao estudo, foram submetidas a um período de 24 horas de adaptação ao ambiente e aos observadores. Ato contínuo, foram divididas aleatoriamente em dois grupos: grupo dexmedetomidina, na dose de 10 μg/Kg (GD) e grupo dexmedetomidina (10 μg/Kg) associado com morfina, na dose de 0,3 mg/Kg (GDM), administrados pela via intramuscular (IM). Ato contínuo, as pacientes foram induzidas com propofol e mantidas com isoflurano diluído em oxigênio 100% e administrado através de vaporizador calibrado. Para verificação da analgesia pós-operatória foram realizadas avaliações de dor por meio de escalas de Glasgow Modificada (EGM) e de Melbourne (EM). Para avaliação de sedação, por meio da escala de Dobbins (ED), em diferentes tempos: antes da administração da MPA (T0), e em mais 6 tempos no período pós-operatório, uma (T1), duas (T2), quatro (T3), oito (T4), 12 (T5) e 24 (T6) horas após a extubação orotraqueal. Não foram observadas diferenças estatísticas entre os grupos nas escalas de acordo com o teste de Kruskal-Wallis post-hoc de Dunn; e entre os tempos notou-se diferença estatística pelo teste de Friedman (p<0,05) para EGM e EM, porém não houve necessidade de resgate analgésico. Portanto, conclui-se que a dexmedetomidina isolada e associada a morfina produziu efeito analgésico adequado no período pós-operatório de cadelas submetidas a OH.

This study aimed to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and when associated with morphine in patients under general inhalational anesthesia with isoflurane and undergoing elective ovariohysterectomy (OH). Twenty healthy bitches were selected via physical and laboratory examinations. Prior to the study, they underwent a 24-h period of adaptation to the environment and observers. They were then randomly divided into two groups: the dexmedetomidine group receiving a dose of 10 μg/kg, and dexmedetomidine group (10 μg/kg) associated with morphine receiving a dose of 0.3 mg/kg, administered via the intramuscular route. Thereafter, patients were induced with propofol and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer. To verify postoperative analgesia, pain assessments were performed using the modified Glasgow (EGM) and Melbourne (EM) scales. For sedation assessment, the Dobbins scale was used at different times: before the administration of pre-anesthetic medication (T0) and at another six times in the postoperative period, 1 (T1), 2 (T2), 4 (T3), 8 (T4), 12 (T5), and 24 (T6) h after orotracheal extubation. No statistical differences were observed between groups in the scales according to Dunn’s Kruskal-Wallis post hoc test, and between the times a statistical difference was noticed by the Friedman test (p<0.05) for the EGM and EM scale scores, but there was no need for analgesic rescue. Therefore, we found that isolated dexmedetomidine and morphine produced adequate analgesic effects in the postoperative period of bitches submitted for OH.

Comparison of intraoperative nociception and postoperative acute pain after traditional or minimally invasive ovariohysterectomy in dogs

Many variations of ovariohysterectomy techniques have been described, including the traditional one and minimally invasive procedures. Non-laparoscopic Snook hook technique is an alternative for performing minimally invasive ovariohysterectomy. Few studies have been carried out in order to assess pain in animals submitted to minimally invasive surgeries, especially involving one of the most performed surgical procedures in veterinary practice. The aim of this study was to evaluate surgical duration, intraoperative nociception and acute postoperative pain after traditional ovariohysterectomy or minimally invasive non-laparoscopic technique in dogs using Snook hook. The hypothesis is that non-laparoscopic minimally invasive ovariohysterectomy would be faster and less painful than the conventional technique. Thirty dogs were divided into Traditional Group (TG = 15) and Minimally Invasive Group (MIG = 15). Heart rate, respiratory rate, systolic blood pressure, body temperature, oxyhemoglobin saturation, end-tidal carbon dioxide concentration (ETCO2) and end-tidal isoflurane concentration were evaluated before the surgery begins (M0), during incision (M1), clamping of the first ovarian pedicle (M2), second ovarian pedicle (M3), uterine cervix (M4), abdominal suture (M5) and at the end of surgery (M6). The modified Glasgow Pain Scale was used for acute postoperative pain assessment and Visual Analogue Scale (VAS) was used to assess the sensitivity of surgical wound. The level of significance established for all statistical analysis was 5%. Statistical differences were not observed between groups considering total surgical time and postoperative acute pain intensity (P > 0.05), in spite of MIG having shorter duration of surgery. There was no statistical difference between groups considering all intraoperative parameters except respiratory rate (TG < MIG; P < 0.05) and ETCO2 (MIG < TG; P < 0.05) at the moment of traction of the first ovarian pedicle (M2). Pain assessment by VAS showed statistical difference 24h after the end of surgery (TG < MIG) (P < 0.05). Both procedures were similar regarding intraoperative nociception and acute postoperative pain. It is possible that the sensation of pain in both procedures was blocked by the effectiveness of analgesics, once they might cause an inhibition of painful behaviors limiting a possible difference in pain identification. Higher respiratory stress observed in MIG at M2 and higher pain score by VAS noted in MIG 24 h after the end of surgery can be justified by greater traction of ovarian pedicle, due to limited surgical access of minimally invasive technique. Minimally invasive ovariohysterectomy non-laparoscopic seems to be potentially faster, probably due to the smaller size of the abdominal incision, which takes less time to be closed. In the present study, both techniques were performed by an experienced surgeon, providing safe procedures, nevertheless it is important to emphasize that iatrogenic injury can be caused by surgeons non-proficient in the Snook hook technique, considering the limited visualization of anatomical abdominal structures. Data obtained indicate that traditional ovariohysterectomy and non-laparoscopic Snook hook technique promote similar intraoperative nociception and acute postoperative pain, however minimally invasive procedure is potentially faster with less surgical trauma.(AU)

Postoperative evaluation of analgesia promoted by the use of dexmedetomidine alone and associated with morphine as an intramuscular pre-anesthetic medication in bitches submitted for ovariohysterectomy / Avaliação pós-operatória da analgesia promovida pelo uso da dexmedetomidina isolada e associada à morfina em cadelas submetidas à ovariohisterectomia

This study aimed to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and when associated with morphine in patients under general inhalational anesthesia with isoflurane and undergoing elective ovariohysterectomy (OH). Twenty healthy bitches were selected via physical and laboratory examinations. Prior to the study, they underwent a 24-h period of adaptation to the environment and observers. They were then randomly divided into two groups: the dexmedetomidine group receiving a dose of 10 µg/kg, and dexmedetomidine group (10 µg/kg) associated with morphine receiving a dose of 0.3 mg/kg, administered via the intramuscular route. Thereafter, patients were induced with propofol and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer. To verify postoperative analgesia, pain assessments were performed using the modified Glasgow (EGM) and Melbourne (EM) scales. For sedation assessment, the Dobbins scale was used at different times: before the administration of pre-anesthetic medication (T0) and at another six times in the postoperative period, 1 (T1), 2 (T2), 4 (T3), 8 (T4), 12 (T5), and 24 (T6) h after orotracheal extubation. No statistical differences were observed between groups in the scales according to Dunn's Kruskal-Wallis post hoc test, and between the times a statistical difference was noticed by the Friedman test (p<0.05) for the EGM and EM scale scores, but there was no need for analgesic rescue. Therefore, we found that isolated dexmedetomidine and morphine produced adequate analgesic effects in the postoperative period of bitches submitted for OH.

Objetivou-se avaliar a eficácia analgésica pós-operatória da dexmedetomidina isolada e associada à morfina em pacientes submetidas à anestesia geral inalatória com isoflurano e submetidas à ovariohisterectomia eletiva (OH). Vinte cadelas saudáveis foram selecionadas a partir de exames físico e laboratoriais. Previamente ao estudo, foram submetidas a um período de 24 horas de adaptação ao ambiente e aos observadores. Ato contínuo, foram divididas aleatoriamente em dois grupos: grupo dexmedetomidina, na dose de 10 µg/Kg (GD) e grupo dexmedetomidina (10 µg/Kg) associado com morfina, na dose de 0,3 mg/Kg (GDM), administrados pela via intramuscular (IM). Ato contínuo, as pacientes foram induzidas com propofol e mantidas com isoflurano diluído em oxigênio 100% e administrado através de vaporizador calibrado. Para verificação da analgesia pós-operatória foram realizadas avaliações de dor por meio de escalas de Glasgow Modificada (EGM) e de Melbourne (EM). Para avaliação de sedação, por meio da escala de Dobbins (ED), em diferentes tempos: antes da administração da MPA (T0), e em mais 6 tempos no período pós-operatório, uma (T1), duas (T2), quatro (T3), oito (T4), 12 (T5) e 24 (T6) horas após a extubação orotraqueal. Não foram observadas diferenças estatísticas entre os grupos nas escalas de acordo com o teste de Kruskal-Wallis post-hoc de Dunn; e entre os tempos notou-se diferença estatística pelo teste de Friedman (p<0,05) para EGM e EM, porém não houve necessidade de resgate analgésico. Portanto, conclui-se que a dexmedetomidina isolada e associada a morfina produziu efeito analgésico adequado no período pós-operatório de cadelas submetidas a OH.

Evaluation of post-operative pain and stress in dogs after elective ovariohysterectomy under hospitalization / Avaliação da dor e estresse pós-operatórios em cadelas mantidas em ambiente hospitalar submetidas à ovariohisterectomia eletiva

Surgical procedures in pet animals are usually associated with some degree of stress and pain. Hospitalization is one stress-triggering factor. The present study aimed to evaluate the degree of stress and pain during hospitalization of female dogs submitted to elective ovariohysterectomy (OVH) and to investigate the influence of hospitalization on the stress of these animals. Fifteen young adult crossbreed female dogs were divided into two groups: eight animals without surgery (Group 1 - control) and seven animals submitted to surgery (Group 2 - OVH). Pain and stress were evaluated. Visual analogue scale (VAS), simple descriptive pain scale (SDS) and modified Glasgow pain scale (MGPS) were used. Serum cortisol (g/dL) and glucose (mg/dl) were also measured. No statistical difference was observed for cortisol (g/dL) between the two groups. Despite the absence of statistical difference between groups and times, mean serum cortisol (g/dL) values exceeded the normal values for the canine species at various times evaluated. Hyperglycemia was only observed at T4 in the OVH group. It was concluded that the hospitalization of animals was more relevant in the establishment of stress than the surgical procedure and associated pain. The influence of stress was a relevant factor in the resu

Os procedimentos cirúrgicos em animais de companhia são geralmente associados a algum grau de dor e estresse e a hospitalização é um dos fatores que predispõem ao estresse. O presente estudo teve o objetivo de avaliar o grau de estresse e dor durante a internação de cadelas submetidas à ovariohisterectomia eletiva (OVH) e investigar a influência da hospitalização sobre o estresse nestes animais. Quinze cadelas adultas jovens e mestiças foram divididas em dois grupos: oito animais não submetidos à cirurgia (Grupo 1 - controle) e sete animais submetidos à OVH (Grupo 2 - OVH). Dor e estresse foram avaliados. Foram utilizadas a escala visual analógica (EVA), escala descritiva simples (EDS) e escala de dor de Glasgow modificada (EDGM). A glicose (mg/dL) e o cortisol (g/dL) séricos foram mensurados. Não houve diferença estatística do cortisol (g/dL) entre os grupos. Entretanto, os valores médios de cortisol (g/dL) excederam àqueles considerados normais para a espécie canina em vários períodos avaliados. A hiperglicemia foi observada em T4 no grupo OVH. Concluiu-se que a hospitalização dos animais foi mais relevante na ocorrência do estresse do que o procedimento cirúrgico e a dor associada a ele. Desta forma, a influência do estresse foi um fator relevante nos resultados das avaliaçõ

Evaluation of post-operative pain and stress in dogs after elective ovariohysterectomy under hospitalization / Avaliação da dor e estresse pós-operatórios em cadelas mantidas em ambiente hospitalar submetidas à ovariohisterectomia eletiva

Surgical procedures in pet animals are usually associated with some degree of stress and pain. Hospitalization is one stress-triggering factor. The present study aimed to evaluate the degree of stress and pain during hospitalization of female dogs submitted to elective ovariohysterectomy (OVH) and to investigate the influence of hospitalization on the stress of these animals. Fifteen young adult crossbreed female dogs were divided into two groups: eight animals without surgery (Group 1 - control) and seven animals submitted to surgery (Group 2 - OVH). Pain and stress were evaluated. Visual analogue scale (VAS), simple descriptive pain scale (SDS) and modified Glasgow pain scale (MGPS) were used. Serum cortisol (g/dL) and glucose (mg/dl) were also measured. No statistical difference was observed for cortisol (g/dL) between the two groups. Despite the absence of statistical difference between groups and times, mean serum cortisol (g/dL) values exceeded the normal values for the canine species at various times evaluated. Hyperglycemia was only observed at T4 in the OVH group. It was concluded that the hospitalization of animals was more relevant in the establishment of stress than the surgical procedure and associated pain. The influence of stress was a relevant factor in the resu

Os procedimentos cirúrgicos em animais de companhia são geralmente associados a algum grau de dor e estresse e a hospitalização é um dos fatores que predispõem ao estresse. O presente estudo teve o objetivo de avaliar o grau de estresse e dor durante a internação de cadelas submetidas à ovariohisterectomia eletiva (OVH) e investigar a influência da hospitalização sobre o estresse nestes animais. Quinze cadelas adultas jovens e mestiças foram divididas em dois grupos: oito animais não submetidos à cirurgia (Grupo 1 - controle) e sete animais submetidos à OVH (Grupo 2 - OVH). Dor e estresse foram avaliados. Foram utilizadas a escala visual analógica (EVA), escala descritiva simples (EDS) e escala de dor de Glasgow modificada (EDGM). A glicose (mg/dL) e o cortisol (g/dL) séricos foram mensurados. Não houve diferença estatística do cortisol (g/dL) entre os grupos. Entretanto, os valores médios de cortisol (g/dL) excederam àqueles considerados normais para a espécie canina em vários períodos avaliados. A hiperglicemia foi observada em T4 no grupo OVH. Concluiu-se que a hospitalização dos animais foi mais relevante na ocorrência do estresse do que o procedimento cirúrgico e a dor associada a ele. Desta forma, a influência do estresse foi um fator relevante nos resultados das avaliaçõ

Evaluation of post-operative pain and stress in dogs after elective ovariohysterectomy under hospitalization / Avaliação da dor e estresse pós-operatórios em cadelas mantidas em ambiente hospitalar submetidas à ovariohisterectomia eletiva

Surgical procedures in pet animals are usually associated with some degree of stress and pain. Hospitalization is one stress-triggering factor. The present study aimed to evaluate the degree of stress and pain during hospitalization of female dogs submitted to elective ovariohysterectomy (OVH) and to investigate the influence of hospitalization on the stress of these animals. Fifteen young adult crossbreed female dogs were divided into two groups: eight animals without surgery (Group 1 - control) and seven animals submitted to surgery (Group 2 - OVH). Pain and stress were evaluated. Visual analogue scale (VAS), simple descriptive pain scale (SDS) and modified Glasgow pain scale (MGPS) were used. Serum cortisol (µg/dL) and glucose (mg/dl) were also measured. No statistical difference was observed for cortisol (µg/dL) between the two groups. Despite the absence of statistical difference between groups and times, mean serum cortisol (µg/dL) values exceeded the normal values for the canine species at various times evaluated. Hyperglycemia was only observed at T4 in the OVH group. It was concluded that the hospitalization of animals was more relevant in the establishment of stress than the surgical procedure and associated pain. The influence of stress was a relevant factor in the results of assessments carried out using the MGPS.(AU)

Os procedimentos cirúrgicos em animais de companhia são geralmente associados a algum grau de dor e estresse e a hospitalização é um dos fatores que predispõem ao estresse. O presente estudo teve o objetivo de avaliar o grau de estresse e dor durante a internação de cadelas submetidas à ovariohisterectomia eletiva (OVH) e investigar a influência da hospitalização sobre o estresse nestes animais. Quinze cadelas adultas jovens e mestiças foram divididas em dois grupos: oito animais não submetidos à cirurgia (Grupo 1 - controle) e sete animais submetidos à OVH (Grupo 2 - OVH). Dor e estresse foram avaliados. Foram utilizadas a escala visual analógica (EVA), escala descritiva simples (EDS) e escala de dor de Glasgow modificada (EDGM). A glicose (mg/dL) e o cortisol (µg/dL) séricos foram mensurados. Não houve diferença estatística do cortisol (µg/dL) entre os grupos. Entretanto, os valores médios de cortisol (µg/dL) excederam àqueles considerados normais para a espécie canina em vários períodos avaliados. A hiperglicemia foi observada em T4 no grupo OVH. Concluiu-se que a hospitalização dos animais foi mais relevante na ocorrência do estresse do que o procedimento cirúrgico e a dor associada a ele. Desta forma, a influência do estresse foi um fator relevante nos resultados das avaliações realizadas com a escala de dor de Glasgow modificada.(AU)

Evaluation of post-operative pain and stress in dogs after elective ovariohysterectomy under hospitalization / Avaliação da dor e estresse pós-operatórios em cadelas mantidas em ambiente hospitalar submetidas à ovariohisterectomia eletiva

Surgical procedures in pet animals are usually associated with some degree of stress and pain. Hospitalization is one stress-triggering factor. The present study aimed to evaluate the degree of stress and pain during hospitalization of female dogs submitted to elective ovariohysterectomy (OVH) and to investigate the influence of hospitalization on the stress of these animals. Fifteen young adult crossbreed female dogs were divided into two groups: eight animals without surgery (Group 1 - control) and seven animals submitted to surgery (Group 2 - OVH). Pain and stress were evaluated. Visual analogue scale (VAS), simple descriptive pain scale (SDS) and modified Glasgow pain scale (MGPS) were used. Serum cortisol (µg/dL) and glucose (mg/dl) were also measured. No statistical difference was observed for cortisol (µg/dL) between the two groups. Despite the absence of statistical difference between groups and times, mean serum cortisol (µg/dL) values exceeded the normal values for the canine species at various times evaluated. Hyperglycemia was only observed at T4 in the OVH group. It was concluded that the hospitalization of animals was more relevant in the establishment of stress than the surgical procedure and associated pain. The influence of stress was a relevant factor in the results of assessments carried out using the MGPS.(AU)

Os procedimentos cirúrgicos em animais de companhia são geralmente associados a algum grau de dor e estresse e a hospitalização é um dos fatores que predispõem ao estresse. O presente estudo teve o objetivo de avaliar o grau de estresse e dor durante a internação de cadelas submetidas à ovariohisterectomia eletiva (OVH) e investigar a influência da hospitalização sobre o estresse nestes animais. Quinze cadelas adultas jovens e mestiças foram divididas em dois grupos: oito animais não submetidos à cirurgia (Grupo 1 - controle) e sete animais submetidos à OVH (Grupo 2 - OVH). Dor e estresse foram avaliados. Foram utilizadas a escala visual analógica (EVA), escala descritiva simples (EDS) e escala de dor de Glasgow modificada (EDGM). A glicose (mg/dL) e o cortisol (µg/dL) séricos foram mensurados. Não houve diferença estatística do cortisol (µg/dL) entre os grupos. Entretanto, os valores médios de cortisol (µg/dL) excederam àqueles considerados normais para a espécie canina em vários períodos avaliados. A hiperglicemia foi observada em T4 no grupo OVH. Concluiu-se que a hospitalização dos animais foi mais relevante na ocorrência do estresse do que o procedimento cirúrgico e a dor associada a ele. Desta forma, a influência do estresse foi um fator relevante nos resultados das avaliações realizadas com a escala de dor de Glasgow modificada.(AU)

Metamizol and scopolamine for conventional or two-port laparoscopic-assisted ovariohysterectomy in dogs

Background: Ovariohysterectomy (OVH) is one of the most applied techniques in Veterinary Medicine. Despite some analgesic protocols being used after this procedure in order to control post operatory pain, there is a lack of knowledge of the efficacy after conventional and two port laparoscopic-assisted techniques in dog female. Although the combined formulation of metamizol and scopolamine is used, there is no knowledge about the efficacy and collateral effects in a 6 h regimen after OVH. The aim of this research was to evaluate the efficacy of metamizol and scopolamine to analgesia after two techniques of OVH in dog female. Materials, Methods & Results: Fifteen adults and healthy dog female were submitted to OVH, being eight to the conventional procedure and seven to video assisted technic with two ports. The patients received a combination of metamizol and scopolamine, 6-6 h during 48 h and were evaluated before surgery, 60 min after extubation and on 1 h interval during the f irst 8 h, and at 12, 18, 24, 36, 48 and 72 h after surgery. For this, the University of Melbourne Pain Scale (UMPS) and the short-form of the Glasgow Composite Measure Pain Scale (CMPS-SF) were applied by three evaluators blinded to surgical technic. Glucoses measurement was realized at 1, 6, 12, 24, 48 and 72 h after surgery. Analgesic rescue was not necessary for any animal. Punctuation of UMPS in GC decreases at 8 h and at 5 h, and to GV at 12 and 24 h. Difference between groups happened at 3 h with larger average to GV; at 48 h the punctuation in GC was lager. Considering CMPS-SF to CG, higher average was observed at 1 h and decreased at 2, 3, 8 and 18. At GV highest average points was verified at 1, 2 and 3 h and decreased at 5, 8 and 18 h. Correlation was strong and positive between each two evaluators. Animals of both groups had increased average...

Dipyrone, scopolamine, and meloxicam for conventional or two-port laparoscopic-assisted ovariohysterectomy in female dogs / Dipirona, escopolamina e meloxicam após ovário-histerectomia convencional ou videoassistida por dois portais em fêmeas caninas

For ethical and organic reasons, surgical and analgesic techniques that minimize and adequately control pain should be studied. Ovariohysterectomy is the most common surgical technique in veterinary medicine and is performed in female dogs for elective or therapeutic purposes. Both conventional and minimally invasive surgical techniques are used in veterinary medicine; however, the minimally invasive laparoscopic technique is considered superior to the conventional technique because it is associated with a less painful and faster post-operative recovery. However, for various reasons, the laparoscopic technique is not yet widely used in veterinary medicine, and the conventional ovariohysterectomy is still the most common. The aim of this study, therefore, was to validate the efficacy of the combination of dipyrone, scopolamine, and meloxicam after conventional or two-port laparoscopic-assisted ovariohysterectomies in female dogs. Additionally, this study sought to assess recovery after the two surgical modalities while receiving the same analgesic protocol. Fourteen healthy adult female dogs were spayed and then evaluated using the Visual Analogue Scale, the Melbourne Scale, and the short form of the Glasgow Composite Measure Pain Scale for 72 hours after surgery. The analgesic protocol was efficient for pain control after both techniques, with minimal differences between the groups.

Devido a razões éticas e orgânicas, técnicas cirúrgicas e analgésicas que minimizam e controlam adequadamente a dor devem estudadas. A ovário-histerectomia é a técnica cirúrgica mais realizada em medicina veterinária, seja aplicada com fins eletivos ou terapêuticos. As técnicas cirúrgicas convencionais e minimamente invasivas são utilizadas em medicina veterinária, e as laparoscópicas são consideradas superiores, pois promovem menor dor e mais rápida recuperação pós-operatória. Embora esta modalidade cirúrgica seja considerada superior, por diferentes razões ainda não é tão difundida na medicina veterinária, sendo a técnica convencional de ovário-histerectomia a mais utilizada em cadelas. Por estas razões, o objetivo deste estudo foi validar a eficácia do protocolo dipirona, escopolamina e meloxicam em cadelas submetidas a ovário-histerectomia convencional ou videoassistida por dois portais, assim como avaliar a recuperação dos animais submetidos a duas modalidades cirúrgicas junto ao referido protocolo analgésico. Assim, 14 cadelas adultas saudáveis foram submetidas a ovário-histerectomia e avaliadas por meio da Escala Visual Analógica, Escala de Melbourne e Forma reduzida da Escala Composta de Glasgow até 72 horas após a realização do procedimento cirúrgico. O protocolo analgésico foi eficiente para controle da dor nos animais submetidos a ambas as técnicas cirúrgicas, e mínimas diferenças foram observadas entre os grupos.

Dipyrone, scopolamine, and meloxicam for conventional or two-port laparoscopic-assisted ovariohysterectomy in female dogs / Dipirona, escopolamina e meloxicam após ovário-histerectomia convencional ou videoassistida por dois portais em fêmeas caninas

For ethical and organic reasons, surgical and analgesic techniques that minimize and adequately control pain should be studied. Ovariohysterectomy is the most common surgical technique in veterinary medicine and is performed in female dogs for elective or therapeutic purposes. Both conventional and minimally invasive surgical techniques are used in veterinary medicine; however, the minimally invasive laparoscopic technique is considered superior to the conventional technique because it is associated with a less painful and faster post-operative recovery. However, for various reasons, the laparoscopic technique is not yet widely used in veterinary medicine, and the conventional ovariohysterectomy is still the most common. The aim of this study, therefore, was to validate the efficacy of the combination of dipyrone, scopolamine, and meloxicam after conventional or two-port laparoscopic-assisted ovariohysterectomies in female dogs. Additionally, this study sought to assess recovery after the two surgical modalities while receiving the same analgesic protocol. Fourteen healthy adult female dogs were spayed and then evaluated using the Visual Analogue Scale, the Melbourne Scale, and the short form of the Glasgow Composite Measure Pain Scale for 72 hours after surgery. The analgesic protocol was efficient for pain control after both techniques, with minimal differences between the groups.(AU)

Devido a razões éticas e orgânicas, técnicas cirúrgicas e analgésicas que minimizam e controlam adequadamente a dor devem estudadas. A ovário-histerectomia é a técnica cirúrgica mais realizada em medicina veterinária, seja aplicada com fins eletivos ou terapêuticos. As técnicas cirúrgicas convencionais e minimamente invasivas são utilizadas em medicina veterinária, e as laparoscópicas são consideradas superiores, pois promovem menor dor e mais rápida recuperação pós-operatória. Embora esta modalidade cirúrgica seja considerada superior, por diferentes razões ainda não é tão difundida na medicina veterinária, sendo a técnica convencional de ovário-histerectomia a mais utilizada em cadelas. Por estas razões, o objetivo deste estudo foi validar a eficácia do protocolo dipirona, escopolamina e meloxicam em cadelas submetidas a ovário-histerectomia convencional ou videoassistida por dois portais, assim como avaliar a recuperação dos animais submetidos a duas modalidades cirúrgicas junto ao referido protocolo analgésico. Assim, 14 cadelas adultas saudáveis foram submetidas a ovário-histerectomia e avaliadas por meio da Escala Visual Analógica, Escala de Melbourne e Forma reduzida da Escala Composta de Glasgow até 72 horas após a realização do procedimento cirúrgico. O protocolo analgésico foi eficiente para controle da dor nos animais submetidos a ambas as técnicas cirúrgicas, e mínimas diferenças foram observadas entre os grupos.(AU)

Tumescent anesthesia or epidural anesthesia combined with intercostal block in bitches submitted to mastectomy / Anestesia local tumescente ou anestesia epidural associada ao bloqueio intercostal em cadelas submetidas à mastectomia

The present study aimed to evaluate the use of tumescent local anesthesia or epidural anesthesia associated with an intercostal nerve block in bitches submitted to mastectomy. Fourteen bitches from the clinical routine of the Veterinary Hospital of the Federal University of Pelotas were premedicated with acepromazine (0.03 mg/kg) and morphine (0.3 mg/kg) intramuscularly, then induced with propofol (2 to 6 mg/kg/IV) and maintained with 1,4V% isoflurane (calibrated vaporizer). The patients were randomly allocated into: GALT Group (n=7), which received tumescent local anesthesia (0.16%) at the dose of 15 mL/kg, and the GEBI Group (n=7) which received epidural anesthesia with lidocaine (5 mg/kg) and morphine (0.1 mg/kg) associated with an intercostal nerve block from the 6th to 12th intercostal space with lidocaine (2 mg/kg). An increase higher than 10% in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were considered as possible signs of nociception, to which fentanyl was administered intravenously as rescue analgesia. Postoperative analgesia was evaluated by means of the modified Glasgow scale at 30, 60, 120, 240 and 360 minutes. There were no differences in physiological parameters (P>0.05) in the transoperative period intra-group and inter-group the groups. The GEBI Group required more frequent transoperative rescue analgesia (9) in comparison to the GALT Group (5), but with no statistical difference. During the postoperative period, there was no need for rescue analgesia in either group. Results suggest that epidural anesthesia associated with intercostal nerve block can be used as an alternative technique in patients with restrictions against the use of local tumescent anesthesia.

O presente estudo objetivou avaliar o uso da anestesia local tumescente ou da anestesia epidural associada ao bloqueio intercostal em cadelas submetidas à mastectomia. Foram utilizadas 14 cadelas, provenientes da rotina do Hospital de Clínicas Veterinária da Universidade Federal de Pelotas, pré-medicadas com acepromazina (0,03 mg/kg) e morfina (0,3 mg/kg) intramuscular, induzidas com propofol (2 a 6 mg/Kg/IV) e mantidas com isofluorano à 1,4 V% (vaporizador calibrado). Após essa etapa, foram alocadas aleatoriamente em grupo GALT (n=7), que recebeu a anestesia local tumescente 0,16% na dose de 15 mL/Kg e em grupo GEBI (n=7), que recebeu como tratamento a anestesia epidural com lidocaína (5 mg/kg) e morfina (0,1 mg/kg) associada ao bloqueio intercostal, do 6º ao 12º espaço intercostal, com lidocaína (2mg/kg). Os parâmetros avaliados para sinais de nocicepção transcirúrgica e realização de resgates analgésicos com fentanil foram: frequência cardíaca, frequência respiratória, pressão arterial sistólica, pressão arterial diastólica e pressão arterial média. No pós-operatório avaliou-se a analgesia pela escala de Glasgow Modificada aos 30, 60, 120, 240 e 360 minutos. Não houve diferenças entre os parâmetros clínicos (p > 0,05) no período transoperatório entre e dentro dos grupos. O GEBI apresentou maior quantidade de resgates analgésicos transoperatórios (9) em relação a GALT (5), porém sem diferenças estatísticas. No pós-operatório, nenhum animal de ambos os grupos atingiu pontuação máxima para resgate analgésico. Pode-se concluir que a anestesia epidural associada ao bloqueio intercostal é uma técnica alternativa para casos em que se tenham limitações para utilização da anestesia local tumescente.