Protocolo anestésico em guaxinim submetido à colocefalectomia / Anesthesic protocol in a raccoon submitted to colocephalectomy

Em guaxinins, comumente se observa a presença de osteoartrites acometendo a articulação coxofemoral. Em carnívoros domésticos, o tratamento pode ser conservativo ou cirúrgico e, dentre as técnicas cirúrgicas, cita-se a colocefalectomia. Por ser um procedimento que provoca dor moderada a severa, um protocolo de anestesia balanceada se faz necessário, podendo associar a técnicas de bloqueio locorregional, como a epidural. Protocolos descritos para a espécie são limitados, porém comumente empregados para contenções químicas, avaliações físicas e exames de imagem. Portanto, o objetivo deste trabalho é relatar a o protocolo anestésico realizado em guaxinim (Procyon cancrivorus) submetido à colocefalectomia. Foram utilizados dexmedetomidina (5µg/kg), cetamina (5mg/kg) e diazepam (0,3mg/kg) por via intramuscular como medicação pré-anestésica, indução com propofol e manutenção por anestesia inalatória com isoflurano. Para execução da anestesia epidural, realizou-se uma abordagem na região lombossacral, sendo administrados bupivacaína (1mg/kg) e morfina (0,1mg/kg). Não houve intercorrências e os parâmetros fisiológicos mantiveram-se estáveis. Descartou-se a necessidade de resgate analgésico e a recuperação anestésica foi rápida. Dessa forma, conclui-se que o manejo anestésico proposto promoveu estabilidade hemodinâmica e recuperação satisfatórias para a espécie.

In raccoons, the presence of osteoarthritis affecting the hip joint is commonly observed. In domestic carnivores, the treatment can be conservative or surgical and, among the surgical techniques, colocephalectomy is mentioned. Since it is a procedure that causes moderate to severe pain, a balanced anesthesia protocol is necessary, which can be associated with locoregional block techniques such as the epidural. Protocols described for the species are limited, being commonly used for chemical restraints, physical assessments, and imaging exams. Therefore, this work aims to report the anesthetic protocol performed on a raccoon (Procyon cancrivorus) submitted to colocephalectomy. Dexmedetomidine (5µg/kg), ketamine (5mg/kg), and diazepam (0.3mg/kg) were used intramuscularly as pre-anesthetic medication, in addition to induction with propofol, and the maintenance by inhalational anesthesia with isoflurane. For epidural anesthesia, an approach was performed in the lumbosacral region, with the administration of bupivacaine (1mg/kg) and morphine (0.1mg/kg). There were no complications and the physiological parameters remained stable. The need for analgesic rescue was ruled out and the anesthetic recovery was fast. Thus, it is concluded that the proposed anesthetic management promoted hemodynamic stability and a satisfactory recovery for the species.

Associação do bloqueio do plano transverso e serrátil em gata submetida à mastectomia / Association of transversus and serratus plane block in cat submitted to mastectomy

Os bloqueios locorregionais são considerados padrão-ouro para a analgesia perioperatória. Sendo assim, este trabalho apresenta o efeito da associação do bloqueio do plano transverso do abdome com o bloqueio do plano serrátil em um felino de 11 anos, fêmea, que foi submetido à mastectomia unilateral. Foi utilizada a metadona 0,3 mg/kg via intramuscular (IM) na medicação pré-anestésica e propofol dose-efeito via intravenosa (IV) para indução, enquanto a manutenção foi feita com isoflurano. O TAP Block e o SP-Block foram realizados unilateralmente utilizando a associação de bupivacaína 0,3mL/kg, em cada ponto, diluída a 0,25% com solução fisiológica. A frequência cardíaca (FC), a frequência respiratória (f), a pressão arterial não invasiva (Método Doppler), a temperatura esofágica (oC), a saturação de oxigênio (SpO2), a capnografia (EtCO2) e o eletrocardiograma foram monitorados continuamente e registrados a cada dez minutos. A paciente foi monitorada por cinco horas, após a extubação, quanto à dor, sendo utilizada, para isso, a Escala Multidimensional de Dor Aguda (UNESP-Botucatu). A recuperação anestésica da paciente foi rápida e sem complicações. Durante a avaliação de dor, o animal apresentou escore zero, não manifestando qualquer desconforto pós-operatório. A associação das técnicas foi eficaz no bloqueio anestésico das paredes torácica e abdominal, sugerindo a inclusão destas nos protocolos de analgesia multimodal para esse tipo de cirurgia.

Locoregional blocks are considered the gold standard for perioperative analgesia. Thus, this paper presents the effect of the association of transverse abdominal plane block with serratus plane block in an 11-year-old female feline submitted to unilateral mastectomy. Methadone 0.3 mg/kg via intramuscular (IM) was used as pre anesthetic medication and dose-effect propofol via intravenous (IV) was used for induction, while the maintenance was done with isofluorane. TAP Block and SP-Block were performed unilaterally using an association of Bupivacaine 0.3 ml/kg at each point, diluted to 0.25% with saline solution. Heart rate (HR), respiratory rate (f), non-invasive blood pressure (Doppler method), esophageal temperature (oC), oxygen saturation (SpO2), capnography (EtCO2), and electrocardiogram were monitored continuously and recorded every 10 minutes. The patient was monitored for pain during five hours after extubation using the Multidimensional Scale of UNESP-Botucatu. The anesthetic recovery of the patient was fast and without complications. During pain assessment, the animal presented a score of zero and did not present any postoperative discomfort. The association of techniques was effective in the anesthetic blockade of the thoracic and abdominal walls, suggesting their inclusion in multimodal analgesia protocols for this type of surgery.

Bloqueio do plano transverso do abdômen em coelha submetida à mastectomia e ovariohisterectomia / Blockade of the transverse plane of the abdomen in a rabbit submitted to mastectomy and ovariohysterectomy

Os bloqueios locorregionais vêm sendo cada vez mais estudados na medicina veterinária, principalmente em pets não-convencionais e animais silvestres. O bloqueio do plano transverso do abdômen (TAP block) é uma técnica de anestesia locorregional capaz de promover anestesia e analgesia em regiões da pele, musculatura e peritônio parietal, as quais fazem parte da estratégia de analgesia multimodal. O objetivo deste trabalho é relatar o bloqueio do plano transverso em um coelho doméstico de quatro anos de idade submetido à mastectomia regional e ovariohisterectomia. Foram realizados dois pontos bilateralmente de bloqueio do espaço TAP guiado por ultrassom com 2mg/kg de bupivacaína a 0,25%, padronizando um volume total injetado de 2,4mL. Foram utilizados dexmedetomidina (5É¥g/kg) e midazolam (0,5mg/kg) por via intramuscular como medicação pré-anestésica, indução com isoflurano na máscara de oxigênio 100% e manutenção por anestesia inalatória com isoflurano. Os parâmetros fisiológicos mantiveram-se estáveis, sem necessidade de resgate analgésico, com extubação rápida e despertar tranquilo. Desta forma, conclui-se que o TAP block foi eficaz na analgesia para mastectomia regional e ovariohisterectomia como protocolo multimodal, aumentando o índice de segurança, além de ser de fácil execução mesmo com transdutores de baixa frequência.

The locoregional blocks have been increasingly studied in veterinary medicine, especially in non-conventional pets and wild animals. The transverse abdominis plane block (TAP block) is a locoregional anesthesia technique capable of promoting anesthesia and analgesia in the skin, muscle, and parietal peritoneum regions, which are is part of the multimodal analgesia strategy. This study aims to report the transverse plane block in a four-year-old domestic rabbit submitted to regional mastectomy and ovariohysterectomy. Two ultrasound-guided TAP space blocks were performed bilaterally with 2mg/kg of bupivacaine 0.25%, standardizing a total injected volume of 2.4mL. Dexmedetomidine (5É¥g/kg) and midazolam (0.5mg/kg) were used intramuscularly as pre-anesthetic medication, induction with isoflurane in a 100% oxygen mask, and maintenance by inhalation anesthesia with isoflurane. Physiological parameters remained stable, with no need for analgesic rescue, rapid extubation, and peaceful awakening. Thus, it is concluded that the TAP block was effective in analgesia for regional mastectomy and ovariohysterectomy as a multimodal protocol, increasing the safety index. Moreover, it is easy to perform even with low-frequency transducers.

Multimodal anesthesia associated with regional block in a dog who underwent corrective surgery for persistent right aortic arch: case report / Anestesia multimodal associada a bloqueio loco-regional em cão submetido a cirurgia corretiva para persistência de arco aórtico direito: relato de caso

The persistence of the fourth right aortic arch (PRAA) is a congenital malformation that affects the heart base's main vessels. Surgical treatment is recommended and should be advocated as a matter of urgency. In this context, efficient anesthesia planning is necessary, with satisfactory analgesia, associating multimodal techniques with regional blocks. The present work aims to report the anesthetic procedure during corrective surgery for PRAA in a dog. Neuroleptanalgesia was intramuscularly performed, using acepromazine (0.015 mg.kg-1) and methadone (0.3 mg.kg-1) in pre-anesthetic medication. Ketamine (1 mg.kg-1) and propofol (3 mg.kg-1) were administered at induction, both intravenously, followed by maintenance using total intravenous anesthesia with propofol (initial rate of 0.4 mg.kg-1 .minute) and remifentanil, (0.2 mcg.kg.-1.minute). In addition, ultrasound-guided regional intercostal block was performed, with 5% bupivacaine without vasoconstrictor (0.05ml.kg-1). Ketamine infusion was postoperatively maintained for one hour. The instituted protocol proved to be satisfactory in controlling trans and postoperative pain, maintaining all parameters stable during and after the procedure, without any intercurrence. Thus, the protocol provided quality recovery to the patient.(AU)

A persistência do quarto arco aórtico direito é uma má formação congênita, afetando os principais vasos da base cardíaca. O tratamento cirúrgico é recomendado e preconiza-se um planejamento anestésico eficiente, associando-se técnicas multimodais a bloqueios regionais. O presente trabalho objetiva relatar a anestesia durante cirurgia corretiva de PDA em cão. Na medicação pré-anestésica, instituiu-se neuroleptonalgesia, utilizando-se acepromazina (0,015 mg.kg-1) e metadona (0,3 mg.kg-1), por via intramuscular. Na indução, foi administrada cetamina (1mg.kg -1) e propofol (3 mg.kg-1). Para manutenção, utilizou--se propofol (taxa inicial de 0,4 mg.kg-1.minuto) e remifentanil, (0,2 mcg.kg-1.minuto). Além disso, foi realizado bloqueio regional intercostal guiado por ultrassom com bupivacaína sem vasoconstritor a 5% (0,05ml.kg-1). O paciente permaneceu em infusão analgésica de cetamina por uma hora, no pós operatório. O protocolo estabelecido demonstrou ser satisfatório no controle de dor trans e pós-operatória, mantendo todos os parâmetros estáveis, sem nenhuma intercorrência, proporcionando qualidade de recuperação ao paciente.(AU)

Lumbar paravertebral block in a rabbit (Oryctolagus cuniculus) submitted to pelvic limb amputation: case report / Bloqueio paravertebral lombar em coelho (Oryctolagus cuniculus) submetido à amputação de membro pélvico: relato de caso

The concern about pain management in exotic mammals is increasing. However, only a few studies describe locoregional anesthesia techniques in rabbits. Thus, this report aims to describe the lumbar paravertebral block, guided by peripheral nerve stimulation, in a rabbit undergoing mid-femoral amputation. We received a one-year-old rabbit weighing 1.27kg with a history of non-union of the right femur and osteomyelitis. The animal came to us for high pelvic limb amputation. After premedication with ketamine, midazolam, and morphine, the patient was maintained under general anesthesia in a non-rebreathing circuit under spontaneous ventilation with isoflurane vaporized in 0.6 oxygen. Using a peripheral nerve stimulator, we performed the lumbar paravertebral block, positioning the needle between the L5 and L6 vertebrae and injecting 0.2mL/kg bupivacaine. The patient remained stable throughout the procedure, without the need for analgesic rescue with opioids during surgery and postoperatively. The discharge occurred after 24 hours. The lumbar paravertebral block proved efficient for trans and postoperative analgesia for high pelvic limbic amputation in rabbits.

A preocupação quanto ao manejo da dor em mamíferos exóticos é crescente, entretanto existem poucos estudos que descrevem o uso de técnicas de anestesia locorregional em coelhos. Assim, este relato tem por objetivo descrever o bloqueio paravertebral lombar guiado por neurolocalizador em um coelho submetido à amputação mediofemoral. Um coelho de um ano de idade e 1,27kg foi atendido com histórico de não união de fêmur direito e osteomielite, sendo encaminhado para amputação alta do membro pélvico. Após pré-medicação com cetamina, midazolam e morfina, o paciente foi mantido sob anestesia geral em circuito sem reinalação de gases, sob ventilação espontânea com isoflurano vaporizado em 0,6 de oxigênio. O bloqueio do plexo lombar foi realizado pela abordagem paravertebral, com o auxílio de neurolocalizador, sendo a agulha posicionada entre as vértebras L5 e L6 e injeção de 0,2mL/kg de bupivacaína 0,5%. O paciente manteve-se estável durante todo o procedimento, sem a necessidade de resgate analgésico com opioides no trans e no pós-operatório. O paciente recebeu alta médica após 24 horas. O bloqueio lombar paravertebral demonstrou-se eficiente para analgesia trans e pós-operatória no procedimento de amputação alta de membro pélvico de coelho.

Hip dislocation in a calf - treatment with iliofemoral suture

Background: Coxofemoral dislocation is uncommon in large animals, due to anatomical particularities that provide greater stability to this joint. The most common causes of hip dislocation in large animals are related to hypocalcemia, mount trauma, sudden falls on hard surfaces or dystocia. Treatment can be performed by closed reduction, but the reported results are not satisfactory with complications. Several surgical techniques have already been described and successfully used in small animals in the treatment of hip dislocation. The present work aims to describe the technique and the result of the iliofemoral suture in the treatment of hip dislocation in a Girolando heifer. Case: A heifer was attended with a history of difficulty in getting up. According to the owner, the clinical manifestation was sudden, after remaining in a paddock with other animals of different age groups. The calf had reduced skin sensitivity on the croup, and it was impossible to remain in the quadrupedal position, often remaining in sternal recumbency with the left pelvic limb in extension. From the clinical examination, spinal cord injury was suspected and clinical treatment was instituted with dexamethasone, vitamins B1, B12 and dimethylsulfoxide. At the end of the clinical treatment, the animal did not show a favorable evolution, so radiographic examination of the coxofemoral region was performed, revealing dislocation of the left femoral head, indicating surgical correction. Xylazine was administered as pre-anesthetic medication, followed by anesthetic induction with midazolam associated with ketamine, followed by orotracheal intubation. Anesthetic maintenance was instituted with isoflurane and monitoring was performed with a multiparameter monitor. An epidural block was performed with bupivacaine and morphine. A craniolateral approach to the left hip joint was performed. After the dislocation was reduced, sutures were used to better stabilize the joint in question. Following the evolution of the surgical procedure, it was possible to confirm that the femoral head remained in place. After 15 days, the skin stitches were removed and the animal was discharged from the hospital and returned to its original property. The calf was asked to remain in the stall for at least 60 days, gradually releasing it into larger spaces and only after 120 days could it remain in the paddock with other animals. During three months, the tutor was consulted about the evolution of the condition, reporting that the animal was clinically well, being able to get up and walk without difficulty and with a mild degree of lameness, thus suggesting the success of the surgical procedure. Discussion: There are few studies of successful surgical treatments of hip dislocation in large animals, and that number is even smaller when considering cattle alone. It is believed that this is due to difficulties related to the surgical technique and to postoperative handling, given the animal's weight. The iliofemoral suture technique performed on the animal in the present study is commonly employed in small animals, and excellent results have been observed. However, reports on the use of this technique in large animals have not been found. The iliofemoral suture technique has advantages over other reported surgical techniques in cattle. When compared to the femoral head and neck resection, the iliofemoral suture has several advantages, as it allows preservation of the joint and achievement of superior biomechanical results. When compared to the technique of reinforcement of the joint capsule with synthetic material, also reported in cattle, the iliofemoral suture appears to be faster, simpler and more economic, and provides similar stability. We conclude that the iliofemoral suture proved to be a satisfactory alternative for the treatment of hip dislocations in young cattle.

Bloqueio do plano serrátil associado ao transverso do abdômen na mastectomia total unilateral em cadela / Blocking of the Serratus Plan associated with the Transverse Abdominis in a total unilateral mastectomy in bitch

A anestesia locorregional, em pequenos animais, está em crescente utilização como forma de promover analgesia para procedimentos cirúrgicos, através do bloqueio reversível da condução do impulso nervoso. Assim, o objetivo deste trabalho foi relatar o uso do bloqueio locorregional do plano serrátil (SP block) associado ao bloqueio locorregional do plano transverso do abdômen (TAP block) em uma cadela da raça Lhasa Apso. A associação de tais bloqueios visou à insensibilização da musculatura na região da cadeia mamária para um procedimento cirúrgico de mastectomia unilateral total. A cadela castrada, foi encaminhada para a mastectomia unilateral total direita, apresentando nódulos nas glândulas mamárias torácica caudal e inguinal. Os bloqueios foram realizados com a paciente em decúbito dorsal, utilizando-se bupivacaína a 0,25%. Em seguida, a paciente foi liberada para o procedimento, o qual foi monitorado. Os parâmetros de eletrocardiografia, frequência respiratória, frequência cardíaca, oximetria de pulso, pressão arterial oscilométrica (composta por pressão arterial sistólica, pressão arterial diastólica e pressão arterial média), capnografia e temperatura esofágica foram anotados a cada dez minutos em uma ficha de avaliação anestésica. Durante a recuperação pós-operatória, foi realizada a avaliação de dor aguda por meio da escala de dor da Universidade de Melbourne. Os resultados demonstram que a associação do TAP block com o SP block foi eficiente em promover analgesia para uma mastectomia total unilateral de cadela.

Locoregional anesthesia in small animals is increasingly used as a way to promote analgesia for surgical procedures, through a reversible block of nerve impulse conduction. Thus, the objective of this study was to report the use of locoregional block of the serratus plane (SP block) associated with the locoregional block of the transverse abdominis plane (TAP block) in a bitch of the Lhasa Apso breed. The association of such blocks aimed to desensitize the musculature in the region of the mammary chain for a surgical procedure of total unilateral mastectomy. The castrated bitch was referred for total right unilateral mastectomy, showing nodules in the caudal thoracic and inguinal mammary glands. The blocks were performed with the patient in dorsal decubitus, using 0.25% bupivacaine. Then, the patient was released for the procedure, which was monitored. The parameters of electrocardiography, respiratory rate, heart rate, pulse oximetry, oscillometric blood pressure (composed of systolic blood pressure, diastolic blood pressure, and mean blood pressure), capnography, and esophageal temperature were recorded every 10 minutes in an anesthetic evaluation form. During the postoperative recovery, acute pain was evaluated using the pain scale of the University of Melbourne. The results demonstrate that the association of TAP block with SP block was efficient in promoting analgesia for a total unilateral mastectomy in a bitch.

Hypersensitivity in chicken (Gallus gallus domesticus) due to the association of lidocaine and bupivacaine in neural-guided femoral and sciatic nerve block

Background: Osteosyntheses, orthopedic surgeries that cause highly painful stimulation, are increasingly common inveterinary medicine. Epidural anesthesia is used to provide intraoperative and postoperative analgesia in mammals undergoing pelvic limb surgery. In birds, the synsacrum, the bone originating from the fusion of the lumbar and sacral vertebrae,makes this route inapplicable, thus peripheral nerve block is an easier option in this species. This report describes a caseof local hypersensitivity following the association of lidocaine and bupivacaine in anesthetic blocks of the femoral andsciatic nerves in chickens (Gallus gallus domesticus).Case: A study was conducted in chickens evaluating the effectiveness of anesthetic sciatic and femoral nerve blocks, guidedby a neural stimulator. Thirty-two 42-day-old male chickens of the species Gallus gallus domesticus, double breasted,weighing 1.86 ± 0.5 kg, were randomly divided into four groups: control (CG), lidocaine (LG), bupivacaine (BC) andthe association of lidocaine and bupivacaine (LBG). The doses used were 4 mg/kg of 2% lidocaine and 2 mg/kg of 0.5%bupivacaine, without vasoconstrictor. For CG, 0.9% NaCl solution was used, respecting the total volume of 1 mL/kg.Only one bird from the LBG showed side effects, presenting sensory and motor loss for 24 h after the administration ofthese drugs, before euthanasia was performed using anesthetic induction with isoflurane through a face mask, followedby the intravenous administration of propofol and then potassium chloride. The chicken was submitted to a necropsy andmacroscopically, soft, irregular, brownish lesions with a grayish focus were observed...

Hypersensitivity in chicken (Gallus gallus domesticus) due to the association of lidocaine and bupivacaine in neural-guided femoral and sciatic nerve block

Background: Osteosyntheses, orthopedic surgeries that cause highly painful stimulation, are increasingly common inveterinary medicine. Epidural anesthesia is used to provide intraoperative and postoperative analgesia in mammals undergoing pelvic limb surgery. In birds, the synsacrum, the bone originating from the fusion of the lumbar and sacral vertebrae,makes this route inapplicable, thus peripheral nerve block is an easier option in this species. This report describes a caseof local hypersensitivity following the association of lidocaine and bupivacaine in anesthetic blocks of the femoral andsciatic nerves in chickens (Gallus gallus domesticus).Case: A study was conducted in chickens evaluating the effectiveness of anesthetic sciatic and femoral nerve blocks, guidedby a neural stimulator. Thirty-two 42-day-old male chickens of the species Gallus gallus domesticus, double breasted,weighing 1.86 ± 0.5 kg, were randomly divided into four groups: control (CG), lidocaine (LG), bupivacaine (BC) andthe association of lidocaine and bupivacaine (LBG). The doses used were 4 mg/kg of 2% lidocaine and 2 mg/kg of 0.5%bupivacaine, without vasoconstrictor. For CG, 0.9% NaCl solution was used, respecting the total volume of 1 mL/kg.Only one bird from the LBG showed side effects, presenting sensory and motor loss for 24 h after the administration ofthese drugs, before euthanasia was performed using anesthetic induction with isoflurane through a face mask, followedby the intravenous administration of propofol and then potassium chloride. The chicken was submitted to a necropsy andmacroscopically, soft, irregular, brownish lesions with a grayish focus were observed...(AU)

Bloqueio do plano transverso do abdômen guiado por ultrassom em felino submetido a mastectomia regional / Blocking of the abdomen transverse plan guided by ultrasound in feline submitted to regional mastectomy

Os bloqueios locorregionais vêm sendo cada vez mais utilizados na medicina veterinária. O bloqueio do plano transverso do abdômen (TAP Block) é uma técnica de anestesia locorregional, faz parte da estratégia de analgesia multimodal, capaz de promover anestesia e analgesia em regiões de pele, musculatura e peritônio parietal. O objetivo deste trabalho é relatar o bloqueio do plano transverso em um felino macho de dois anos de idade submetido a mastectomia regional. Foram feitos dois pontos de bloqueio do espaço TAP guiado por ultrassom, em cada lado do abdômen: um na parte caudal da região abdominal média, cranial a crista ilíaca, e o outro ponto, caudal a última costela, com 0,5mg/kg de bupivacaína a 0,25% em cada ponto, padronizando um volume injetado de 0,6mL. Foi utilizado acepromazina (0,05mg/kg), petidina (3mg/kg), cetamina (2mg/kg) e midazolam (0,3mg/kg) como medicação pré-anestésica, indução com propofol (3mg/kg) e manutenção por anestesia inalatória com isoflurano. Conclui-se que o TAP block foi eficaz para mastectomia regional abdominal, com alto índice de segurança e de fácil execução com treinamento adequado, mesmo com transdutores de baixa frequência.

Locoregional blocks have been increasingly used in veterinary medicine. Blocking the transverse plane of the abdomen (TAP Block) is a technique of locoregional anesthesia, it is part of the multimodal analgesia strategy, capable of promoting anesthesia and analgesia in regions of skin, musculature and parietal peritoneum. The aim of this study is to report the transverse plane block in a two-year-old male cat undergoing regional mastectomy. Two ultrasound-guided TAP space block points were made on each side of the abdomen: one in the caudal part of the middle abodminal region, cranial to the iliac crest, and the other point, caudal to the last rib, with 0.5mg/kg of 0.25% bupivacaine at each point, standardizing an injected volume of 0.6mL. Acepromazine (0.05mg/kg), pethidine (3mg/kg), ketamine (2mg/kg) and midazolam (0.3mg/kg) were used as pre-anesthetic medication, induction with propofol (3mg/kg) and maintenance by inhalation anesthesia with isoflurane. It is concluded that the TAP block was effective for regional abdominal mastectomy, with a high safety index and easy to perform with adequate training, even with less frequent transducers.

Management of urethral obstruction in a cat with epidural sacrococcygeal anesthesia guided by electrical neurostimulation

Background: The treatment for urethral obstruction in cats consists of catheterization, and for this, the cat must be sedated or anesthetized. Sacococcygeal epidural block has the advantage of being close to receptors related to nociception located in the spinal cord and it is safer because it represents lower risk of spinal cord injury or inadvertent application in the subarachnoid space, when compared to the lumbosacral epidural. Nerve stimulation through the neurolocator to identify the epidural space increases the accuracy of this technique. Thus, the objective is to report a case of epidural anesthesia with a sacrococcygeal approach guided by neurostimulation in a cat with urethral obstruction. Case: A 4-year-old male Siamese cat, weighing 4 kg, was referred to the veterinary care with a history of apathy and anorexia for 2 days. From the physical exam, the clinical diagnosis of urethral obstruction was made, and to desobstruction, we chose to perform sacrococcygeal epidural block. Initially, the patient was anesthetized with propofol (4 mg/kg) and midazolam (0.3 mg/kg). To perform the anesthetic block, the cat was placed in sternal decubitus with the hind limbs extended cranially to perform sacrococcygeal epidural block. The positive pole (cathode) was connected to the skin of the right inguinal region at the caudal aspect of the thigh and the neurostimulator was turned on and adjusted to 0.7 mA of stimulating current intensity, 0.1 ms duration and 1 Hz frequency. The needle for electrical neurolocation was introduced in the dorsal midline, perpendicular to the skin surface, between the spinous processes of S3-Cd1 in the skin. The exact injection point was obtained observed by the muscular response of the middle and distal third of the animal's tail with the neurostimulator adjusted to 0.3 mA of intensity, in the same duration and frequency as before. The total volume of 0.9 mL (0.22 mL/kg) of solution containing the combination of 0.6 mL of 0.75% levobupivacaine and 0.3 mL of 2% lidocaine was injected. The success of the block was confirmed by the loss of reflexes of the pelvic limbs and anal sphincter 10 min after the administration of the anesthetic solution. Discussion: In this case, the use of the neurolocator helped to perform an effective sacrococcygeal block, allowing urethral catheterization without the addition of other analgesic agents. This technique desensitizes and relaxes muscles in the regions of the perineum, anus, distal colon and penis, being useful for performing urethral catheterization. The use of smaller anaesthetic volumes to perform sacrococcygeal block makes it possible to achieve a more localized anesthesia, without affecting the motor function of the pelvic limbs. However, in our report, using a combination of levobupivacaine and lidocaine, the pelvic limb block was also verified despite the low volume applied. A hypothesis that could justify the different responses in relation to the pelvic limb block compared to other studies would be due to the different physicalchemical properties of the drugs used. Lidocaine is known to be less fat-soluble than bupivacaine, so it tends to spread more through the epidural space, in order to result in more extensive blocks. The use of a neurostimulator using a fixed electric current of 0.7 mA, pulse 0.1 ms and a frequency of 1 Hz allowed the correct identification of the needle position for the application of the anesthetic.

Topical application of lidocaine or bupivacaine in the healing of surgical wounds in dogs

Purpose: To analyze the anesthetic drugs interference with wound healing when used in the surgical bed. Methods: Macro and microscopic aspects of healing of surgical wounds were evaluated after instillation of topical anesthetics without vasoconstrictor or saline solution 0.9% as control in the transsurgical period. Thirty dogs, males and females were divided into two experimental groups. In both groups, two circular punch lesions of 6 mm diameter were performed in the abdomen. In group 1, lidocaine was instilled in one of the lesions and saline solution in the contralateral lesion. In group 2 the procedure was repeated with the use of bupivacaine. The macroscopic assessment of the lesions was performed on the first, third and tenth postoperative day. The excisional biopsy was performed on the tenth day and the samples were submitted for histopathological examination. Results: The macroscopic analysis had a significant difference between groups. Microscopic analysis was not significant between groups. Conclusions: The topical application of lidocaine and bupivacaine in the surgical wound is feasible and it does not influence skin healing. The benefit of such a practice, which has been the subject of other studies, seems to outweigh the risks.(AU)

Protocolo anestésico para ressecção parcial da parede torácica seguida de reconstrução em cães: relato de dois casos / Anesthetic protocol for thoracic wall resection followed by reconstruction in dogs: a two-case report

O presente trabalho relata o protocolo anestésico utilizado em dois cães submetidos à cirurgia de ressecção e reconstrução da parede torácica devido a neoplasmas, no Hospital Veterinário Roque Quagliato do Centro Universitário das Faculdades Integradas de Ourinhos, São Paulo. Uma cadela poodle de 10 anos e um cão rottweiler de um ano e três meses foram submetidos à anestesia geral com isofluorano, bloqueio intercostal de, respectivamente, seis e sete espaços intercostais com lidocaína 2% e bupivacaína 0,5% e infusão contínua de morfina (0,1 mg/kg/h), lidocaína (50 μg/kg/minuto) e midazolam (0,1 mg/kg/h). No período pós-operatório imediato, ambos receberam administração peridural de morfina 0,2 mg/kg e fentanila 2 μg/kg diluídos com NaCl 0,9% para 0,3 mL/kg. Um tubo de analgesia foi deixado durante as 48 horas subsequentes na ferida cirúrgica para administração de lidocaína e bupivacaína em total de uma dose tóxica por dia, fracionada para cinco aplicações. A prescrição analgésica pós-operatória constituiu-se de tramadol 4 mg/kg e dipirona 25 mg/kg a cada oito horas durante sete dias, juntamente com meloxicam 0,1 mg/kg a cada 24 horas durante três dias. Os animais recuperaram-se tranquilamente e não foram observados sinais de dor ao longo dos sete dias subsequentes. Recomenda-se o protocolo relatado para cirurgias de ressecção da parede torácica em cães.(AU)

It is reported the anesthetic protocol used for two dogs subjected to thoracic wall resection due to neoplasms at the Roque Quagliato Veterinary Hospital, University Center of Integrated Faculties of Ourinhos, São Paulo. A female Poodle aged 10 years and a male rottweiler aged 1.25 years were anesthetized with isoflurane, local anesthesia of respectively six and seven intercostal spaces using 2% lidocaine and 0.5% bupivacaine, and continuous rate infusion of morphine (0.1 mg/kg/h), lidocaine (50 μg/kg/minute) and midazolam (0.1 mg/kg/h). Postoperatively, both animals received epidural morphine at 0.2 mg/kg and fentanyl at 2 μg/kg in 0.9% NaCl for a total volume of 0.3 mL/kg. A wound soaker catheter was left in place during the subsequent 48 hours for administration of lidocaine and bupivacaine at a total of one toxic dose for each day, divided into five applications. Postoperative prescription comprised tramadol at 4 mg/kg and metamizole at 25 mg/kg every eight hours for seven days, and meloxicam 0.1 mg/kg every 24 hours for three days. Both dogs recovered quietly from anesthesia and no signs of pain were detected during the next seven days. This anesthetic protocol is recommended for thoracic wall resection in dogs.(AU)

Protocolo anestésico para ressecção parcial da parede torácica seguida de reconstrução em cães: relato de dois casos / Anesthetic protocol for thoracic wall resection followed by reconstruction in dogs: a two-case report

O presente trabalho relata o protocolo anestésico utilizado em dois cães submetidos à cirurgia de ressecção e reconstrução da parede torácica devido a neoplasmas, no Hospital Veterinário Roque Quagliato do Centro Universitário das Faculdades Integradas de Ourinhos, São Paulo. Uma cadela poodle de 10 anos e um cão rottweiler de um ano e três meses foram submetidos à anestesia geral com isofluorano, bloqueio intercostal de, respectivamente, seis e sete espaços intercostais com lidocaína 2% e bupivacaína 0,5% e infusão contínua de morfina (0,1 mg/kg/h), lidocaína (50 μg/kg/minuto) e midazolam (0,1 mg/kg/h). No período pós-operatório imediato, ambos receberam administração peridural de morfina 0,2 mg/kg e fentanila 2 μg/kg diluídos com NaCl 0,9% para 0,3 mL/kg. Um tubo de analgesia foi deixado durante as 48 horas subsequentes na ferida cirúrgica para administração de lidocaína e bupivacaína em total de uma dose tóxica por dia, fracionada para cinco aplicações. A prescrição analgésica pós-operatória constituiu-se de tramadol 4 mg/kg e dipirona 25 mg/kg a cada oito horas durante sete dias, juntamente com meloxicam 0,1 mg/kg a cada 24 horas durante três dias. Os animais recuperaram-se tranquilamente e não foram observados sinais de dor ao longo dos sete dias subsequentes. Recomenda-se o protocolo relatado para cirurgias de ressecção da parede torácica em cães.

It is reported the anesthetic protocol used for two dogs subjected to thoracic wall resection due to neoplasms at the Roque Quagliato Veterinary Hospital, University Center of Integrated Faculties of Ourinhos, São Paulo. A female Poodle aged 10 years and a male rottweiler aged 1.25 years were anesthetized with isoflurane, local anesthesia of respectively six and seven intercostal spaces using 2% lidocaine and 0.5% bupivacaine, and continuous rate infusion of morphine (0.1 mg/kg/h), lidocaine (50 μg/kg/minute) and midazolam (0.1 mg/kg/h). Postoperatively, both animals received epidural morphine at 0.2 mg/kg and fentanyl at 2 μg/kg in 0.9% NaCl for a total volume of 0.3 mL/kg. A wound soaker catheter was left in place during the subsequent 48 hours for administration of lidocaine and bupivacaine at a total of one toxic dose for each day, divided into five applications. Postoperative prescription comprised tramadol at 4 mg/kg and metamizole at 25 mg/kg every eight hours for seven days, and meloxicam 0.1 mg/kg every 24 hours for three days. Both dogs recovered quietly from anesthesia and no signs of pain were detected during the next seven days. This anesthetic protocol is recommended for thoracic wall resection in dogs.

Anestesia multimodal em cachorro-do-mato (Cerdocyon thous) submetido à hemilaminectomia e estabilização sacrococcígea / Multimodal anaesthesia in a crab-eating fox (Cerdocyon thous) undergoing hemilaminectomy and sacrococcygeal stabilization

Background: Several researches have shown the impacts of roads more directly to wildlife in Brazil. The crab-eating fox(Cerdocyon thous) is a frequent run over victim. Dissociative drugs are commonly used, but inhalation anesthesia is indicatedin cases of extensive and prolonged surgeries. Despite their similarity with domestic dogs, the literature is scarce regarding theassociation of new anesthetic techniques and protocols in wild canids. The aim of this paper was to report the viability of multimodal anesthesia in a crab-eating fox, victim of running over, undergoing hemilaminectomy and sacrococcygeal stabilization.Case: An adult male specimen of crab-eating fox was rescued after being run over and taken to a wild animal screening center.Physical examination showed superficial and deep pain, lack of support for the pelvic limbs and proprioception, increasedreflexes, and reduced tail mobility. Chemical restraint with intramuscular (IM) tiletamine-zolazepam (6.0 mg/kg) and morphine (0.5 mg/kg) was performed. Meloxicam (0.2 mg/kg IM) and enrofloxacin (5.0 mg/kg IM) were also administered. Theanimal was sequentially admitted to the veterinary hospital. Radiographic images showed compaction of the spinal columnof the T10 and T11 thoracic vertebrae and the sacrococcygeal region. Sixty min after chemical restraint, the anesthesia wassupplemented with IM tiletamine-zolazepam (4.5 mg/kg), and fluid therapy with 0.9% NaCl (10 mL/kg/h) was started. Ten minlater, intravenous propofol dose-effect (2.5 mg/kg) was administered and general anesthesia was maintained with isoflurane(FiO2 = 1.0). Thirty min after the induction of anesthesia, the animal was urdergoing hemilaminectomy and sacrococcygealstabilization. Constant rate infusions (CRI) of dexmedetomidine (0.5 μg/kg/h) and ketamine (0.6 mg/kg/h) were started. Lidocaine (7.0 mg/kg) and bupivacaine (2.0 mg/kg) were administered into the surgical site on the T10 and T11 vertebrae at 35...(AU)

Anestesia multimodal em cachorro-do-mato (Cerdocyon thous) submetido à hemilaminectomia e estabilização sacrococcígea / Multimodal anaesthesia in a crab-eating fox (Cerdocyon thous) undergoing hemilaminectomy and sacrococcygeal stabilization

Background: Several researches have shown the impacts of roads more directly to wildlife in Brazil. The crab-eating fox(Cerdocyon thous) is a frequent run over victim. Dissociative drugs are commonly used, but inhalation anesthesia is indicatedin cases of extensive and prolonged surgeries. Despite their similarity with domestic dogs, the literature is scarce regarding theassociation of new anesthetic techniques and protocols in wild canids. The aim of this paper was to report the viability of multimodal anesthesia in a crab-eating fox, victim of running over, undergoing hemilaminectomy and sacrococcygeal stabilization.Case: An adult male specimen of crab-eating fox was rescued after being run over and taken to a wild animal screening center.Physical examination showed superficial and deep pain, lack of support for the pelvic limbs and proprioception, increasedreflexes, and reduced tail mobility. Chemical restraint with intramuscular (IM) tiletamine-zolazepam (6.0 mg/kg) and morphine (0.5 mg/kg) was performed. Meloxicam (0.2 mg/kg IM) and enrofloxacin (5.0 mg/kg IM) were also administered. Theanimal was sequentially admitted to the veterinary hospital. Radiographic images showed compaction of the spinal columnof the T10 and T11 thoracic vertebrae and the sacrococcygeal region. Sixty min after chemical restraint, the anesthesia wassupplemented with IM tiletamine-zolazepam (4.5 mg/kg), and fluid therapy with 0.9% NaCl (10 mL/kg/h) was started. Ten minlater, intravenous propofol dose-effect (2.5 mg/kg) was administered and general anesthesia was maintained with isoflurane(FiO2 = 1.0). Thirty min after the induction of anesthesia, the animal was urdergoing hemilaminectomy and sacrococcygealstabilization. Constant rate infusions (CRI) of dexmedetomidine (0.5 μg/kg/h) and ketamine (0.6 mg/kg/h) were started. Lidocaine (7.0 mg/kg) and bupivacaine (2.0 mg/kg) were administered into the surgical site on the T10 and T11 vertebrae at 35...

Anestesia para nefrectomia em cão com Dioctophyma renale: relato de caso / Anesthesia for nephrectomy in a dog with Dioctophyma renale: case report

A dioctofimose em cães é uma doença parasitária registrada em vários estados do Brasil, incluindo o Rio Grande do Sul que afeta, principalmente, animais errantes que habitam áreas alagadas. A resolução do caso quando atinge apenas um rim é cirúrgica, sendo assim necessária à realização de anestesia geral para o procedimento de nefrectomia unilateral. Dessa forma, a busca por protocolos mais seguros que mantém a integridade renal é fundamental. O objetivo desse trabalho é relatar a anestesia para o procedimento de nefrectomia como tratamento de dioctofimose em um cão errante da cidade de Pelotas-RS. No presente caso, foi realizada medicação pré-anestésica, com acepromazina, cetamina associados amorfina, e indução com propofol. A manutenção do plano anestésico com isoflurano diluído em oxigênio a 100%, e foi ainda realizado o bloqueio epidural com bupivacaína e morfina para dessensibilização regional. Após o término do procedimento cirúrgico o paciente recebeu analgesia pós-operatória com meloxicam, tramadol e dipirona, e permaneceu na internação por 10 dias para monitoração da função renal e tratamento de doença dermatológica concomitante. O protocolo anestésico foi efetivo e sem maiores complicações, após alta médica foi levado para o canil da prefeitura, onde aguarda adoção.

Dioctophymosis in dogs is a parasitic disease registered in several states of Brazil, including Rio Grande do Sul, mainly wandering animals that live in flooded areas. The resolution of the case is only a surgical measure, so it is necessary to perform general anesthesia for the unilateral nephrectomy procedure. In this way, a search for other data that maintains the ri is fundamental. The purpose of this work is to report anesthesia for the nephrectomy procedure as a treatment of dioctosis in a wandering dog in the city of Pelotas, RS. In the present case, premedication with acepromazine, ketamine associated with morphine, and induction with propofol were performed. The maintenance of the anesthetic plan with isoflurane was diluted in 100% oxygen, and it was also performed with epidural block with bupivacaine and morphine for regional desensitization. After the end of the clinical procedure, the patient received postoperative analgesia with meloxicam, tramadol and dipyrone and remained in the hospital for 10 days to monitor renal function and the concomitant dermatology process. The anesthetic protocol was effective and without major complications, after being discharged to the health service, where it was installed.

Osteossíntese femoral associada ao biovidro 60S em tamanduá-bandeira: relato de caso / Femoral osteosynthesis associated with 60s bioglass in tamanduá bandeira: case report

Atropelamentos de animais silvestres são frequentes e muitas vezes causam fraturas ósseas que, se não tratadas adequadamente, levam à morte do animal por complicações ou por inabilidade de sobrevivência no seu habitat natural. O objetivo do presente trabalho foi relatar o uso de placa associada ao pino intramedular e ao biovidro 60S (BV60S) para o tratamento de fratura de fêmur em tamanduá-bandeira. O animal foi resgatado pela polícia ambiental com suspeita de atropelamento. Foi sedado para avaliação clínica e radiográfica, que revelou fratura em fêmur direito. Utilizou-se dexmedetomidina como medicação pré-anestésica, midazolam e cetamina para indução, e isoflurano para manutenção. Também foi realizado bloqueio peridural com bupivacaína e morfina. A osteossíntese foi feita com placa bloqueada 2,7 e pino intramedular 2,5. Colocaram-se 4g de BV60S no foco de fratura para favorecer a osteogênese. O paciente teve recuperação funcional imediata do membro acometido. A reparação óssea ocorreu por segunda intenção, observando-se ossificação completa do calo com consolidação clínica, aos 30 dias, e remodelação quase completa, aos 180 dias. Conclui-se que o uso de placa e pino associado ao BV60S é eficiente no tratamento de fratura de fêmur em tamanduá, permitindo a rápida recuperação e a reintrodução do animal na natureza.(AU)

Roadblocks of wild animals are frequent and often cause bone fractures that if not properly treated lead to the death of the animal due to complications or inability to survive in its natural habitat. The objective of the present study was to report the use of plate rod and bioglass 60S (BG60S) for the treatment of femoral fracture in anteater. The animal was rescued by environmental police on suspicion of being hit. It was sedated for clinical and radiographic evaluation, which revealed a fracture in the right femur. Dexmedetomidine was used as preanesthetic medication, midazolam and ketamine for induction, and isoflurane for maintenance. Epidural blockade with bupivacaine and morphine was also performed. Osteosynthesis was done with a locking plate 2.7 and 2.5 intramedullary pin. 4G of BG60S was placed in the focus of fracture to favor osteogenesis. The patient had immediate functional recovery of the affected limb. The bone repair occurred by second intention, with complete ossification of the callus with clinical consolidation at 30 days, and near complete remodeling at 180 days. It is concluded that the use of plate rod to the BG60S is efficient in the treatment of femur fracture in anteater, allowing the rapid recovery and reintroduction of the animal in the wild.(AU)

Osteossíntese femoral associada ao biovidro 60S em tamanduá-bandeira: relato de caso / Femoral osteosynthesis associated with 60s bioglass in tamanduá bandeira: case report

Atropelamentos de animais silvestres são frequentes e muitas vezes causam fraturas ósseas que, se não tratadas adequadamente, levam à morte do animal por complicações ou por inabilidade de sobrevivência no seu habitat natural. O objetivo do presente trabalho foi relatar o uso de placa associada ao pino intramedular e ao biovidro 60S (BV60S) para o tratamento de fratura de fêmur em tamanduá-bandeira. O animal foi resgatado pela polícia ambiental com suspeita de atropelamento. Foi sedado para avaliação clínica e radiográfica, que revelou fratura em fêmur direito. Utilizou-se dexmedetomidina como medicação pré-anestésica, midazolam e cetamina para indução, e isoflurano para manutenção. Também foi realizado bloqueio peridural com bupivacaína e morfina. A osteossíntese foi feita com placa bloqueada 2,7 e pino intramedular 2,5. Colocaram-se 4g de BV60S no foco de fratura para favorecer a osteogênese. O paciente teve recuperação funcional imediata do membro acometido. A reparação óssea ocorreu por segunda intenção, observando-se ossificação completa do calo com consolidação clínica, aos 30 dias, e remodelação quase completa, aos 180 dias. Conclui-se que o uso de placa e pino associado ao BV60S é eficiente no tratamento de fratura de fêmur em tamanduá, permitindo a rápida recuperação e a reintrodução do animal na natureza.(AU)

Roadblocks of wild animals are frequent and often cause bone fractures that if not properly treated lead to the death of the animal due to complications or inability to survive in its natural habitat. The objective of the present study was to report the use of plate rod and bioglass 60S (BG60S) for the treatment of femoral fracture in anteater. The animal was rescued by environmental police on suspicion of being hit. It was sedated for clinical and radiographic evaluation, which revealed a fracture in the right femur. Dexmedetomidine was used as preanesthetic medication, midazolam and ketamine for induction, and isoflurane for maintenance. Epidural blockade with bupivacaine and morphine was also performed. Osteosynthesis was done with a locking plate 2.7 and 2.5 intramedullary pin. 4G of BG60S was placed in the focus of fracture to favor osteogenesis. The patient had immediate functional recovery of the affected limb. The bone repair occurred by second intention, with complete ossification of the callus with clinical consolidation at 30 days, and near complete remodeling at 180 days. It is concluded that the use of plate rod to the BG60S is efficient in the treatment of femur fracture in anteater, allowing the rapid recovery and reintroduction of the animal in the wild.(AU)

Evaluation of intraperitoneal and incisional bupivacaine or levobupivacaine for postoperative analgesia in ovariohysterectomized dogs

Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companionanimals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such asmammarian tumours and pyometra. Traditional OHE intervention causes inflammation and pain due to trauma duringorgan manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administrationof bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg wereused in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). Theanimals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE.The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenouslyinjected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV)and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained byadministration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia.All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equalvolume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then appliedover the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayedto left and right, or cranial and caudal parts of the abdominal cavity...