Assessment of thermal response, cardiorespiratory parameters and post-operative analgesia in dogs undergoing ovariohysterectomy with different combinations of epidural analgesia and isoflurane

This study aimed to evaluate the thermal response of the eyelids and lacrimal gland of the left eye (LETG) through infrared thermography (IRT), cardiorespiratory parameters, and their association with nociception and pain in bitches undergoing elective ovariohysterectomy (OVH) anesthetized with isoflurane and epidural analgesia. Twenty-one healthy bitches of different breeds were randomized into three groups receiving epidural blocks: GL (n=7), lidocaine (2 mg Kg-1 ); GLF (n=7), lidocaine (2 mg Kg-1 ) and fentanyl (3 µg Kg-1 ); and GLM (n=7), lidocaine (2 mg Kg-1 ) with morphine (0.1 mg Kg-1 ). IRT and cardiorespiratory parameters were evaluated at baseline (Ebasal), thirty minutes before anesthetic premedication, and at different surgical events: first incision (EInc), ligature and section of the left (ELoV), and right (ERoV) ovarian pedicle, ligature, and re-section of the cervix (EUt), and skin suture (ESut). The assessment of acute pain in the immediate post-operative period was registered at E1h, E2h, and E3h using IRT, the Dynamic Interactive Visual Analogic Scale (DIVAS), and the University of Melbourne Pain Scale (UMPS) scales. The results showed a statistically significant decrease in the lower eyelid surface temperature (LELT) during EInc for GL (32.9°C ± 0.62), in comparison to GLF (34.2°C ± 0.62) and GLM (35.3°C ± 0.62) (P = 0.006). Regarding LETG, a significant increase (P = 0.03) in the IRT of Ebasal (36.8°C ± 0.63) and EInc (36.1°C ± 0.63) for GLM was observed in comparison to the thermographic values for both perioperative events and groups. The GLM showed a significant decrease in IRT values of ERoV at E3h in the upper and lower eyelids (P = 0.03 and P = 0.01, respectively). A progressive and significant reduction of the IRT values of LETG was also recorded in GLM, with differences in ERoV (35.2 °C ± 0.63) (P = 0.02) and E3h (35.3 °C ± 0.63) (P = 0.01). The cardiovascular parameters (SAP, DAP, and MAP) did not differ between treatments, but in GL, there was a significant difference (P = 0.01) during EInc and ESut, compared to Ebasal. In the body temperature, EInc and ESut gradually decreased in all treatment groups (P = 0.01). In conclusion, hemodynamic and cardiorespiratory stability was associated with IRT readings and the absence of nociception. Changes in superficial temperature in the immediate post-operative period were lessened using isoflurane and epidural analgesia of lidocaine alone or in combination with pure opioids. These findings were clinically validated to the DIVAS and UMPS acute pain assessment scales.

Effects of ketamine, midazolam and methadone, combined with local anesthesia, in cats undergoing orchiectomy / Efeitos da cetamina, midazolam e metadona, associados à anestesia local, em gatos submetidos à orquiectomia

Different anesthetic combinations are used for orchiectomy in cats. This study aimed to evaluate the anesthetic and cardiopulmonary effects on the physiological variables of ketamine (10 mg/kg), midazolam (0.2 mg/kg) and methadone (0.3 mg/kg), combined with local anesthesia, in cats undergoing orchiectomy (n = 19 cats). The time for lateral recumbency, degree of sedation, muscle relaxation and nociception were recorded preoperatively. The propofol rescue dose was recorded. The time to head up and quality of recovery were evaluated postoperatively. The time for lateral recumbency was 5 ± 2 minu-tes. Fifteen minutes after the administration of the ketamine-midazolam-methadone combination, a greater sedative effect, muscle relaxation and less response to noxious stimulation were observed. Propofol was administered to twelve cats under local anesthesia, at a total dose of 1.5 ± 0.8 mg/kg. Surgery was started 28 ± 5 minutes after the administration of ketamine--midazolam-methadone combination. There were no differences in the physiological variables evaluated over the other evalu-ation times (p > 0.05). The recovery quality scores were adequate, and the time to head up was 51 ± 10 minutes. Under the conditions of this study, the ketamine-midazolam-methadone combination did not allow local anesthesia for orchiectomy. Many cats required propofol rescue prior to surgery. This combination promoted minimal changes in physiological variables and prolonged anesthetic recovery.(AU)

Diferentes combinações anestésicas são usadas para orquiectomia em gatos. O objetivo deste estudo foi avaliar o efeito anestésico e as alterações promovidas nas variáveis fisiológicas pela cetamina (10 mg/kg), midazolam (0.2 mg/kg) e metadona (0.3 mg/kg), combinados com anestesia local, em gatos submetidos à orquiectomia (n = 19 gatos). O tempo para adoção do decúbito lateral, grau de sedação, relaxamento muscular e nocicepção foram registrados no pré-operatório. A dose de resgate de propofol foi registrada. O tempo para o gato erguer a cabeça e a qualidade da recuperação foram avaliados no pós-operatório. O tempo para adoção do decúbito lateral foi de 5 ± 2 minutos. Quinze minutos após a administração da associação cetamina-midazolam-metadona, observou-se maior efeito sedativo e relaxamento muscular, e menor resposta à estimulação nociva. O propofol foi administrado em doze gatos para realização de anestesia local, utilizando a dose total de 1.5 ± 0.8 mg/kg. A cirurgia foi iniciada 28 ± 5 minutos após a administração de cetamina-midazolam-metadona. Não houve diferença nas variáveis fisiológicas avaliadas em relação aos demais tempos de avaliação (p > 0.05). Os escores de qualidade de recuperação foram adequados e o tempo para o gato erguer a cabeça foi de 51 ± 10 minutos. Nas condições deste estudo, cetamina-midazolam-metadona não permitiu a realização da anestesia local para orquiectomia. Muitos gatos precisaram de resgate com propofol antes de iniciar a cirurgia. Essa associação promoveu alterações mínimas nas variáveis fisiológicas e longa recuperação anestésica.(AU)

Assessment of general activity and anxiety-like behavior in mice following tramadol and meloxicam administration for managing immediate post-operative pain

After analgesic administration, we evaluated general activity in the Open-Field and anxiety-like behavior in the Elevated Plus Maze of vasectomized mice. We divided C57BL/6J male mice into eight groups: saline, three non-operated control groups treated with 10 mg/kg meloxicam, 20 mg/kg tramadol, or both intraperitoneally, and four vasectomized mice groups treated with the same analgesic protocol as the control groups. One group of vasectomized mice received both treatments and an additional 10 mg/kg lidocaine at the incision site. We conducted the vasectomy via scrotal approach under isoflurane inhalation anesthesia and performed behavioral tests after full anesthesia recovery. Mice treated with meloxicam demonstrated low ambulation, spontaneous activity, and rearing frequency. Mice treated with tramadol showed spontaneous behavior compared with the saline control. Due to behavior changes demonstrated by meloxicam controls, we were unable to identify whether meloxicam provided adequate analgesia. Vasectomized mice treated with tramadol showed general activity behavior similar to their control but displayed significantly less rearing, suggesting that they were under potential signs of pain or discomfort. In conclusion, the Open Field test and the Elevated Plus Maze can usefully pre-evaluate analgesic protocols to identify possible interference caused by adverse drug effects. For future directions, an appropriate regimen of meloxicam and tramadol for enhancing mice welfare post vasectomy should be better investigated.

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)

Efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina na medicação pré-anestésica de cadelas submetidas à ovariohisterectomia eletiva / Cardiorespiratory effects of dexmedetomidine alone and associated to morphine as premedicants in healthy bitches undergoing ovariohisterectomy / Efectos cardiorespiratorios de la dexmedetomidina aislada y asociada con morfina sobre medicamentos pre-anestésicos de perras sometidas a ovariohisterectomía electiva

Objetivou-se avaliar os efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina em pacientes submetidas à anestesia geral inalatória com isoflurano e submetidas à ovariohisterectomia eletiva. Vinte cadelas saudáveis foram selecionadas a partir de exames físico e laboratoriais. Os animais foram distribuídos aleatoriamente em dois grupos: dexmedetomidina (10 µg/Kg) (GD) e dexmedetomidina (10 µg/Kg) associado com morfina 0,3 mg/Kg (GDM), administrados pela via intramuscular (IM). Ato contínuo, o paciente foi induzido com propofol (à efeito) e mantido com isoflurano diluído em oxigênio 100% e administrado através de vaporizador calibrado. Foram aferidos os parâmetros fisiológicos: frequências cardíaca (FC) e respiratória (f), temperatura corporal (T°C), pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM), saturação de oxigênio na hemoglobina (SpO2), pressão parcial de gás carbônico no final da expiração (ETCO2) e isoflurano expirado (ETISO). A hemogasometria arterial foi utilizada para a análise do potencial hidrogeniônico (pH), bicarbonato (HCO3-) e pressão parcial de dióxido de carbono (PaCO2). O procedimento cirúrgico teve duração máxima de 45 minutos. Os parâmetros demonstraram diferença estatística entre os tempos e grupos avaliados, de acordo com os testes de Tukey e Bonferroni (p<0,05). Observou-se bradicardia 30 minutos após a aplicação da medicação pré-anestésica e acidemia no período trans-anestésico. Apesar disto, tanto a dexmedetomidina isolada quanto associada, conferiram estabilidade hemodinâmica e respiratória, apesar da bradicardia e acidemia observada.(AU)

This study aimed to evaluate the cardiorespiratory effects of dexmedetomidine alone and associated with morphine. Twenty healthy dogs were selected from physical and laboratory exams. The animals were randomly distributed into two groups: 10 µg/Kg dexmedetomidine (DG) and 10 µg/Kg dexmedetomidine group associated with 0.3 mg/Kg morphine (GDM), administered intramuscularly (IM). The patients were induced with propofol (to effect) and maintained with isoflurane diluted in 100% oxygen and administered through a calibrated vaporizer. Physiological parameters were measured: heart rate (HR), respiratory rate (f), body temperature (T°C), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP), oxygen saturation of hemoglobin (SpO2), end-tidal carbon dioxide partial pressure (ETCO2) and end-tidal isoflurane concentration (ETISO). Arterial blood gas analysis was used to analyze hydrogen potential (pH), bicarbonate (HCO3-) and partial pressure of carbon dioxide (PaCO2). The surgical procedure lasted up to 45 minutes. The parameters showed a statistical difference between the times and groups evaluated, according to the Tukey and Bonferroni tests (p<0.05). Bradycardia was observed 30 minutes after the application of pre-anesthesic medication and acidemia in the trans-anesthetic period. Despite this, both dexmedetomidine alone and associated, provided good hemodynamic and respiratory stability, despite the bradycardia and acidemia observed.(AU)

Este estudio tuvo como objetivo evaluar los efectos cardiorrespiratorios de la dexmedetomidina sola y asociada con la morfina en pacientes sometidas a anestesia general por inhalación con isoflurano y sometidas a ovariohisterectomía electiva. Se seleccionaron veinte perras sanas a partir de exámenes físicos y de laboratorio. Los animales se dividieron aleatoriamente en dos grupos: dexmedetomidina (10 µg/kg) (GD) y dexmedetomidina (10 µg/kg) asociada con 0,3 mg/kg de morfina (GDM), administrada por vía intramuscular (IM). Posteriormente, el paciente fue inducido con propofol (en efecto) y mantenido con isoflurano diluido en oxígeno al 100% y administrado mediante de un vaporizador calibrado. Se midieron parámetros fisiológicos: frecuencia cardíaca (FC) y respiratoria (f), temperatura corporal (T°C), presión arterial sistólica (PAS), diastólica (PAD) y media (PAM), saturación de oxígeno de hemoglobina (SpO2), presión parcial de carbono dióxido al final de la expiración (ETCO2) e isoflurano expirado (ETISO). Se utilizó gasometría arterial para analizar el potencial de hidrógeno (pH), el bicarbonato (HCO3-) y la presión parcial de dióxido de carbono (PaCO2). El procedimiento quirúrgico tuvo una duración máxima de 45 minutos. Los parámetros mostraron diferencia estadística entre los tiempos y grupos evaluados, según las pruebas de Tukey y Bonferroni (p <0.05). Se observó bradicardia 30 minutos después de la aplicación de medicación preanestésica y acidemia en el período transnestésico. A pesar de esto, tanto la dexmedetomidina aislada como la asociada proporcionaron estabilidad hemodinámica y respiratoria, a pesar de la bradicardia y acidemia observadas.(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.

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.

Ropivacaína isolada ou associada à metadona ou à morfina, pela via epidural, em cadelas submetidas à ovário-histerectomia / Ropivacaine sole or associated to methadone or morphine, by epidural route, in bitches undergoing ovariohysterectomy

Objetivou-se avaliar os efeitos fisiológicos, sedativos e analgésicos da administração peridural de ropivacaína isolada ou associada à morfina ou à metadona. Para tal, 24 cadelas submetidas à ovário-histerectomia receberam acepromazina, e a anestesia foi induzida e mantida com propofol e isoflurano (FiO2 = 1,0), respectivamente. De acordo com o protocolo peridural, formaram-se três grupos de igual número: GR (ropivacaína - 2,0mg/kg); GRMETA (ropivacaína - 2,0mg/kg e metadona - 0,3mg/kg) e GRMORF (ropivacaína - 2,0mg/kg e morfina - 0,1mg/kg). Registraram-se os parâmetros fisiológicos intraoperatórios e os graus de sedação e analgesia pós-operatórios. No GR constataram-se maiores médias de pressões arteriais 30 minutos após a anestesia epidural em relação ao GRMETA (sistólica e média) e ao final do procedimento cirúrgico comparativamente ao GRMORF (sistólica, diastólica e média). Não foram observadas diferenças significativas entre os grupos relativamente à analgesia e ao grau de sedação pós-operatórios. A administração epidural de ropivacaína é segura e eficaz e proporciona boa analgesia, independentemente da sua associação com morfina ou metadona.(AU)

The aim of this study was to evaluate the physiological, sedative and analgesic effects of epidural administration of ropivacaine sole or associated to morphine or methadone. Twenty-four bitches were submitted to ovariohysterectomy and received acepromazine and after, propofol and isoflurane (FiO 2 = 1.0) for anesthesia induction and maintenance, respectively. Based on established epidural protocol (L7-S1), three groups were formed: GR (ropivacaine - 2.0mg/kg); GRMETA (ropivacaine - 2.0mg/kg and methadone - 0.3mg/kg) and GRMORF (ropivacaine - 2.0mg/kg and morphine - 0.1mg/kg). Intraoperative physiological parameters and degrees of postoperative sedation and analgesia were recorded. In the GR, the means of arterial pressures, 30 minutes after epidural anesthesia, were higher compared with GRMETA (systolic and mean) and, at the end of the clinical procedure, compared to GRMORF (systolic, diastolic and mean). Differences between groups were not observed for postoperative analgesia and degree of sedation. Epidural administration of ropivacaine is safe and effective and provides good analgesia regardless of its association with morphine or methadone.(AU)

Avaliação pós-cirúrgica do impacto analgésico do tramadol epidural, quando associado à levobupivacaína, em cadelas submetidas à mastectomia e à ovariohisterectomia / Post-surgical evaluation of the analgesic impact of epidural tramadol, when associated with levobupivacaine, in bitches undergoing mastectomy and ovariohysterectomy

Background: Mammary tumors are the most common neoplasms in female dogs. Surgical removal of the mammary glandchain is considered the standard treatment and is usually performed along with ovariohysterectomy (OH) to suppressovarian hormonal influence. Mastectomies cause moderate to severe pain and require preferential multimodal analgesicprotocols. The aim of this study was to compare the postoperative analgesic efficacy and the recovery times on femaledogs undergoing mastectomies and OH between those treated with epidural levobupivacaine alone and those treated withassociated doses of tramadol and anesthetized with propofol.Materials, Methods & Results: Eighteen female dogs were pretreated with acepromazine (0.03 mg/kg), using propofol(4 mg/kg) for induction and anesthesia maintenance. The dogs were randomly divided into three groups (n = 6) treatedwith epidural anesthesia with levobupivacaine alone at 1.5 mg/kg (GL) or associated with tramadol at doses of 2 mg/kg(GLT2) or 4 mg/kg (GLT4). After anesthesia, the mean propofol infusion rate for each group were calculed. During thepostoperative period, the degree of analgesia according to the University of Melbourne Pain Scale for 6 hours were determined, considering seven time points for evaluation (M30, M60, M90, M120, M180, M240, and M360). Supplementalanalgesia with morphine (0.5 mg/kg) to those dogs with scores ≥13 were provided. During the recovery period, the timeintervals between the end of anesthesia, and the following events: extubation (EX), the first head movement (MC), and theestablishment of sternal (PE) and quadrupedal (PQ) positions were measured. Data were subjected to the Friedman testfor analysis of non-parametric variables within the same group and to the Mann–Whitney test for independent variables,comparing the mean scores between groups (statistical significance was set at P < 0.05). In the GL group, a higher meanpropofol infusion rate than in either the ...

Avaliação pós-cirúrgica do impacto analgésico do tramadol epidural, quando associado à levobupivacaína, em cadelas submetidas à mastectomia e à ovariohisterectomia / Post-surgical evaluation of the analgesic impact of epidural tramadol, when associated with levobupivacaine, in bitches undergoing mastectomy and ovariohysterectomy

Background: Mammary tumors are the most common neoplasms in female dogs. Surgical removal of the mammary glandchain is considered the standard treatment and is usually performed along with ovariohysterectomy (OH) to suppressovarian hormonal influence. Mastectomies cause moderate to severe pain and require preferential multimodal analgesicprotocols. The aim of this study was to compare the postoperative analgesic efficacy and the recovery times on femaledogs undergoing mastectomies and OH between those treated with epidural levobupivacaine alone and those treated withassociated doses of tramadol and anesthetized with propofol.Materials, Methods & Results: Eighteen female dogs were pretreated with acepromazine (0.03 mg/kg), using propofol(4 mg/kg) for induction and anesthesia maintenance. The dogs were randomly divided into three groups (n = 6) treatedwith epidural anesthesia with levobupivacaine alone at 1.5 mg/kg (GL) or associated with tramadol at doses of 2 mg/kg(GLT2) or 4 mg/kg (GLT4). After anesthesia, the mean propofol infusion rate for each group were calculed. During thepostoperative period, the degree of analgesia according to the University of Melbourne Pain Scale for 6 hours were determined, considering seven time points for evaluation (M30, M60, M90, M120, M180, M240, and M360). Supplementalanalgesia with morphine (0.5 mg/kg) to those dogs with scores ≥13 were provided. During the recovery period, the timeintervals between the end of anesthesia, and the following events: extubation (EX), the first head movement (MC), and theestablishment of sternal (PE) and quadrupedal (PQ) positions were measured. Data were subjected to the Friedman testfor analysis of non-parametric variables within the same group and to the Mann–Whitney test for independent variables,comparing the mean scores between groups (statistical significance was set at P < 0.05). In the GL group, a higher meanpropofol infusion rate than in either the ...(AU)

Ropivacaína isolada ou associada à metadona ou à morfina, pela via epidural, em cadelas submetidas à ovário-histerectomia / Ropivacaine sole or associated to methadone or morphine, by epidural route, in bitches undergoing ovariohysterectomy

Objetivou-se avaliar os efeitos fisiológicos, sedativos e analgésicos da administração peridural de ropivacaína isolada ou associada à morfina ou à metadona. Para tal, 24 cadelas submetidas à ovário-histerectomia receberam acepromazina, e a anestesia foi induzida e mantida com propofol e isoflurano (FiO2 = 1,0), respectivamente. De acordo com o protocolo peridural, formaram-se três grupos de igual número: GR (ropivacaína - 2,0mg/kg); GRMETA (ropivacaína - 2,0mg/kg e metadona - 0,3mg/kg) e GRMORF (ropivacaína - 2,0mg/kg e morfina - 0,1mg/kg). Registraram-se os parâmetros fisiológicos intraoperatórios e os graus de sedação e analgesia pós-operatórios. No GR constataram-se maiores médias de pressões arteriais 30 minutos após a anestesia epidural em relação ao GRMETA (sistólica e média) e ao final do procedimento cirúrgico comparativamente ao GRMORF (sistólica, diastólica e média). Não foram observadas diferenças significativas entre os grupos relativamente à analgesia e ao grau de sedação pós-operatórios. A administração epidural de ropivacaína é segura e eficaz e proporciona boa analgesia, independentemente da sua associação com morfina ou metadona.(AU)

The aim of this study was to evaluate the physiological, sedative and analgesic effects of epidural administration of ropivacaine sole or associated to morphine or methadone. Twenty-four bitches were submitted to ovariohysterectomy and received acepromazine and after, propofol and isoflurane (FiO 2 = 1.0) for anesthesia induction and maintenance, respectively. Based on established epidural protocol (L7-S1), three groups were formed: GR (ropivacaine - 2.0mg/kg); GRMETA (ropivacaine - 2.0mg/kg and methadone - 0.3mg/kg) and GRMORF (ropivacaine - 2.0mg/kg and morphine - 0.1mg/kg). Intraoperative physiological parameters and degrees of postoperative sedation and analgesia were recorded. In the GR, the means of arterial pressures, 30 minutes after epidural anesthesia, were higher compared with GRMETA (systolic and mean) and, at the end of the clinical procedure, compared to GRMORF (systolic, diastolic and mean). Differences between groups were not observed for postoperative analgesia and degree of sedation. Epidural administration of ropivacaine is safe and effective and provides good analgesia regardless of its association with morphine or methadone.(AU)

Efficacy of use of tramadol in analgesia of prepubertal queens submitted to ovaryhysterectomy / Eficácia do uso de tramadol na analgesia de gatas pré púberes submetidas à ovariohisterectomia

É crescente o número de animais errantes nos grandes centros urbanos, sendo a população de felinos bastante significativa. A esterilização pré púbere promove de forma precoce a incapacidade reprodutiva do animal; reduz o desenvolvimento de patologias relacionadas ao trato reprodutivo, além de outras vantagens. Entretanto a anestesia em animais pré púberes ainda é um desafio e o uso de opióides nestes pacientes tem sido questionado devido a ocorrência de hipotensão em alguns casos. Sendo assim tornam-se necessários estudos para verificar as consequências do uso de opióides nestes animais. Portanto, o presente estudo teve como objetivo avaliar a eficiência do uso de Tramadol em gatas pré-púberes submetidas à ovariosalpingohisterectomia. Foram utilizadas oito fêmeas da espécie felina, com idade entre dois e quatro meses. As gatas foram divididas aleatoriamente em dois grupos (grupo Controle e grupo Tramadol), constituídos de 4 animais cada. Durante o trans operatório foram avaliadas a temperatura corporal, frequência respiratória, frequência cardíaca e saturação de oxigênio e pressão arterial não invasiva. Foram aferidos imediatamente antes da administração das drogas anestésicas (T0 – Controle) e a cada 4 minutos durante o transoperatório de 20 minutos (T4, T8, T12,T16, T20); os parâmetros de frequência cardíaca; frequência respiratória, temperatura corporal, nível de saturação de oxigênio e pressão arterial sistólica (PAS). O grupo Tramadol apresentou valores de frequência cardíaca e respiratória inferiores quando comparados com os obtidos no grupo Controle nos períodos de T0 até o T8. Em todos os momentos analisados a temperatura corporal e saturação de oxigênio não revelaram diferença significativa entre os dois grupos; sendo que os valores se mantiveram entre 35,6°C a 37,7°C e 78,5% a 90,25% respectivamente. Neste estudo foi possível concluir que o Tramadol foi eficiente na analgesia após esterilização...

The number of wandering animals in large urban centers is increasing, and the cat population is quite significant. Pre-pubertal sterilization promotes early reproductive failure of the animal; reduces the development of pathologies related to the reproductive tract, in addition of other advantages. However, anesthesia in prepubertal animals is still a challenge and the usage of opioids in those patient has been questioned due to the occurrence of hypotension in some cases. Accordingly, it is necessary further studies to verify the consequences of the use of opioids in these animals. Therefore, the present study had as objective to evaluate the effectiveness of the use of Tramadol in prepubescent queens submitted to ovariohisterectomy. Eight females of the feline species, aged between two and four months, were used. The queens were randomly divided into two groups (Control group and Tramadol group), consisting of four animals each. During the transoperative period, body temperature, respiratory rate, heart rate and oxygen saturation, and noninvasive blood pressure had been monitored. They have been measured immediately prior to administration of anesthetic drugs (T0 – Control) and every 4 minutes during 20 minute of transoperative period (T4, T8, T12, T16, T20); heart rate parameters; respiratory rate, body temperature, oxygen saturation level and systolic blood pressure (SBP). The Tramadol group presented lower values – of heart rate and respiratory rate when compared to those obtained in the Control group in the periods from T0 to T8. In all analyzed moments body temperature and oxygen saturation did not reveal significant difference between the two groups; with values – between 35.6° C and 37.7° C and 78.5% and 90.25%, respectively. In this study it was possible to conclude that Tramadol was efficient in analgesia after surgical sterilization of prepubertal cats, without causing significant hypotension.

Avaliação dos efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina em cadelas submetidas à ovariossalpingohisterectomia eletiva sob anestesia geral inalatória / Evaluation of cardiorespiratory effects of dexmedetomidine isolated and associated with morphine in bitches submitted to elective ovariossalpingohisterectomy under general inhalation anesthesia

Background: Elective ovariossalpingohysterectomy is one of the most accomplished surgeries in veterinary practice, presenting moderate degree of pain. Aiming at balanced anesthesia, α2-agonists have been increasingly used, with dexmedetomidine being characterized by its sympatholytic, sedative, analgesic properties and synergism with opioids, benzodiazepines and other drugs. The objective of this study was to evaluate the effects of dexmedetomidine alone and associated with morphine under the cardiovascular, respiratory and body temperature variables in the pre and trans-operative periods in bitches submitted to elective ovariossalpingohisterectomy under general inhalation anesthesia.Materials, Methods & Results: Sixteen bitches were used in this study, which were submitted to elective ovariossalpingohisterectomy, all of which were clinically healthy based on clinical and hematological results. The animals were randomized into two groups, in which intramuscular dexmedetomidine alone and 5 µg/kg (DG) and 0.3 mg/kg morphine (GDM). In both groups, anesthesia was induced with propofol administered and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the weight of the animal and kept under spontaneous ventilation. After stabilization of the patient, the surgical procedure started, which lasted 45 min. The parameters evaluated were heart rate (HR), respiratory rate (ƒ), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body temperature (TºC), expired isoflurane concentration , partial carbon dioxide gas pressure (ETCO2 ) and oxygen saturation in hemoglobin (SatO2 ), which were measured before and after the application of preanesthetic medication and at specific surgical times:[...]

Avaliação dos efeitos cardiorrespiratórios da dexmedetomidina isolada e associada à morfina em cadelas submetidas à ovariossalpingohisterectomia eletiva sob anestesia geral inalatória / Evaluation of cardiorespiratory effects of dexmedetomidine isolated and associated with morphine in bitches submitted to elective ovariossalpingohisterectomy under general inhalation anesthesia

Background: Elective ovariossalpingohysterectomy is one of the most accomplished surgeries in veterinary practice, presenting moderate degree of pain. Aiming at balanced anesthesia, α2-agonists have been increasingly used, with dexmedetomidine being characterized by its sympatholytic, sedative, analgesic properties and synergism with opioids, benzodiazepines and other drugs. The objective of this study was to evaluate the effects of dexmedetomidine alone and associated with morphine under the cardiovascular, respiratory and body temperature variables in the pre and trans-operative periods in bitches submitted to elective ovariossalpingohisterectomy under general inhalation anesthesia.Materials, Methods & Results: Sixteen bitches were used in this study, which were submitted to elective ovariossalpingohisterectomy, all of which were clinically healthy based on clinical and hematological results. The animals were randomized into two groups, in which intramuscular dexmedetomidine alone and 5 µg/kg (DG) and 0.3 mg/kg morphine (GDM). In both groups, anesthesia was induced with propofol administered and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the weight of the animal and kept under spontaneous ventilation. After stabilization of the patient, the surgical procedure started, which lasted 45 min. The parameters evaluated were heart rate (HR), respiratory rate (ƒ), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body temperature (TºC), expired isoflurane concentration , partial carbon dioxide gas pressure (ETCO2 ) and oxygen saturation in hemoglobin (SatO2 ), which were measured before and after the application of preanesthetic medication and at specific surgical times:[...](AU)

Efficacy of use of tramadol in analgesia of prepubertal queens submitted to ovaryhysterectomy / Eficácia do uso de tramadol na analgesia de gatas pré púberes submetidas à ovariohisterectomia

É crescente o número de animais errantes nos grandes centros urbanos, sendo a população de felinos bastante significativa. A esterilização pré púbere promove de forma precoce a incapacidade reprodutiva do animal; reduz o desenvolvimento de patologias relacionadas ao trato reprodutivo, além de outras vantagens. Entretanto a anestesia em animais pré púberes ainda é um desafio e o uso de opióides nestes pacientes tem sido questionado devido a ocorrência de hipotensão em alguns casos. Sendo assim tornam-se necessários estudos para verificar as consequências do uso de opióides nestes animais. Portanto, o presente estudo teve como objetivo avaliar a eficiência do uso de Tramadol em gatas pré-púberes submetidas à ovariosalpingohisterectomia. Foram utilizadas oito fêmeas da espécie felina, com idade entre dois e quatro meses. As gatas foram divididas aleatoriamente em dois grupos (grupo Controle e grupo Tramadol), constituídos de 4 animais cada. Durante o trans operatório foram avaliadas a temperatura corporal, frequência respiratória, frequência cardíaca e saturação de oxigênio e pressão arterial não invasiva. Foram aferidos imediatamente antes da administração das drogas anestésicas (T0 Controle) e a cada 4 minutos durante o transoperatório de 20 minutos (T4, T8, T12,T16, T20); os parâmetros de frequência cardíaca; frequência respiratória, temperatura corporal, nível de saturação de oxigênio e pressão arterial sistólica (PAS). O grupo Tramadol apresentou valores de frequência cardíaca e respiratória inferiores quando comparados com os obtidos no grupo Controle nos períodos de T0 até o T8. Em todos os momentos analisados a temperatura corporal e saturação de oxigênio não revelaram diferença significativa entre os dois grupos; sendo que os valores se mantiveram entre 35,6°C a 37,7°C e 78,5% a 90,25% respectivamente. Neste estudo foi possível concluir que o Tramadol foi eficiente na analgesia após esterilização...(AU)

The number of wandering animals in large urban centers is increasing, and the cat population is quite significant. Pre-pubertal sterilization promotes early reproductive failure of the animal; reduces the development of pathologies related to the reproductive tract, in addition of other advantages. However, anesthesia in prepubertal animals is still a challenge and the usage of opioids in those patient has been questioned due to the occurrence of hypotension in some cases. Accordingly, it is necessary further studies to verify the consequences of the use of opioids in these animals. Therefore, the present study had as objective to evaluate the effectiveness of the use of Tramadol in prepubescent queens submitted to ovariohisterectomy. Eight females of the feline species, aged between two and four months, were used. The queens were randomly divided into two groups (Control group and Tramadol group), consisting of four animals each. During the transoperative period, body temperature, respiratory rate, heart rate and oxygen saturation, and noninvasive blood pressure had been monitored. They have been measured immediately prior to administration of anesthetic drugs (T0 Control) and every 4 minutes during 20 minute of transoperative period (T4, T8, T12, T16, T20); heart rate parameters; respiratory rate, body temperature, oxygen saturation level and systolic blood pressure (SBP). The Tramadol group presented lower values of heart rate and respiratory rate when compared to those obtained in the Control group in the periods from T0 to T8. In all analyzed moments body temperature and oxygen saturation did not reveal significant difference between the two groups; with values between 35.6° C and 37.7° C and 78.5% and 90.25%, respectively. In this study it was possible to conclude that Tramadol was efficient in analgesia after surgical sterilization of prepubertal cats, without causing significant hypotension.(AU)

Efeitos adversos da morfina, metadona e tramadol no pós-operatório de cães submetidos à cirurgia da coluna vertebral: 180 casos (2011-2016) / Adverse effects of morphine, methadone and tramadol in the postoperative period of dogs undergone vertebral surgery: 180 cases (2011-2016)

A dor pós-operatória em cães que são submetidos a cirurgias da coluna vertebral é considerada severa e seu manejo inadequado pode influenciar no tempo de recuperação do paciente, na qualidade de vida e no resultado cirúrgico. Dentre os analgésicos indicados para uso no pós-operatório dessas cirurgias tem-se os opioides, que podem apresentar inúmeros efeitos adversos que requerem atenção. Devido à escassez de estudos clínicos acerca desse assunto em se tratando do pós-operatório de cães, objetivou-se com o presente estudo retrospectivo apresentar os efeitos adversos da morfina, metadona e tramadol utilizados no pós-operatório de cirurgias da coluna vertebral. Foram revisadas e avaliadas as fichas de 180 cães e anotadas as alterações observadas no pós-operatório e decorrentes do uso de opioides. Os principais efeitos adversos observados foram anorexia, hiporexia, vômito, salivação, vocalização, bradicardia, hipotermia, ofegação e sedação. Também foi observada persistência da dor em alguns cães mesmo com o uso de analgésicos. Houve diferença na ocorrência de anorexia nos cães tratados com morfina e nos tratados com metadona em relação aos tratados com tramadol. Ocorreu diferença também entre a observação de dor dos grupos morfina e tramadol. A associação de dipirona com morfina e com metadona não revelou diferença com relação à ocorrência de efeitos adversos, bem como a variação de doses. Conclui-se que a morfina, a metadona e o tramadol apresentam efeitos adversos quando empregados para tratamento da dor pós-operatória em cães submetidos à cirurgia da coluna vertebral; a anorexia, a hiporexia e o vômito foram os efeitos adversos frequentes com o uso de morfina e de metadona e, mesmo que o tramadol apresente menor ocorrência desses efeitos, seu uso, na dose estudada, pode não ser vantajoso quando se leva em consideração o grau de dor para cirurgias da coluna vertebral.(AU)

Postoperative pain in dogs undergone vertebral surgery is classified as severe and it's important an adequate approach to it, because it can influence recovery time, quality of life and surgery outcome. Opioids are indicated for postoperative pain treatment in these surgeries. Opioids may have adverse effects that may require attention. There are few clinical studies that present the adverse effects of these analgesics in canine postoperative period. The aim of this retrospective study was to present the adverse effects of morphine, methadone and tramadol in canine vertebral surgery postoperative period. There were revised the postoperative records of 180 dogs and the changes resulted from the opioids use were noted. The adverse effects observed were anorexia, hyporexia, vomiting, vocalization, bradycardia, hypothermia, panting, sedation. Pain was also observed in some dogs. A significant difference was found in anorexia between dogs treated with morphine and tramadol and methadone and tramadol. Significant difference was also found in pain between dogs treated with morphine and tramadol. The association of metamizole and morphine or metamizole and methadone was not different in relation to the adverse effects. There was also no difference with the dosage variation and the adverse effects. In conclusion, morphine, methadone and tramadol have adverse effects when used for pain control in the postoperative period of dogs submitted to vertebral surgery. Anorexia, hypophagia and emesis were frequent the adverse effects observed with morphine and methadone and, despite tramadol presented less adverse effects, its use may be not beneficial in the studied doses when we consider the degree of pain, however more controlled studies with clinical situation are needed to confirm this.(AU)

Efeitos adversos da morfina, metadona e tramadol no pós-operatório de cães submetidos à cirurgia da coluna vertebral: 180 casos (2011-2016) / Adverse effects of morphine, methadone and tramadol in the postoperative period of dogs undergone vertebral surgery: 180 cases (2011-2016)

A dor pós-operatória em cães que são submetidos a cirurgias da coluna vertebral é considerada severa e seu manejo inadequado pode influenciar no tempo de recuperação do paciente, na qualidade de vida e no resultado cirúrgico. Dentre os analgésicos indicados para uso no pós-operatório dessas cirurgias tem-se os opioides, que podem apresentar inúmeros efeitos adversos que requerem atenção. Devido à escassez de estudos clínicos acerca desse assunto em se tratando do pós-operatório de cães, objetivou-se com o presente estudo retrospectivo apresentar os efeitos adversos da morfina, metadona e tramadol utilizados no pós-operatório de cirurgias da coluna vertebral. Foram revisadas e avaliadas as fichas de 180 cães e anotadas as alterações observadas no pós-operatório e decorrentes do uso de opioides. Os principais efeitos adversos observados foram anorexia, hiporexia, vômito, salivação, vocalização, bradicardia, hipotermia, ofegação e sedação. Também foi observada persistência da dor em alguns cães mesmo com o uso de analgésicos. Houve diferença na ocorrência de anorexia nos cães tratados com morfina e nos tratados com metadona em relação aos tratados com tramadol. Ocorreu diferença também entre a observação de dor dos grupos morfina e tramadol. A associação de dipirona com morfina e com metadona não revelou diferença com relação à ocorrência de efeitos adversos, bem como a variação de doses. Conclui-se que a morfina, a metadona e o tramadol apresentam efeitos adversos quando empregados para tratamento da dor pós-operatória em cães submetidos à cirurgia da coluna vertebral; a anorexia, a hiporexia e o vômito foram os efeitos adversos frequentes com o uso de morfina e de metadona e, mesmo que o tramadol apresente menor ocorrência desses efeitos, seu uso, na dose estudada, pode não ser vantajoso quando se leva em consideração o grau de dor para cirurgias da coluna vertebral.(AU)

Postoperative pain in dogs undergone vertebral surgery is classified as severe and it's important an adequate approach to it, because it can influence recovery time, quality of life and surgery outcome. Opioids are indicated for postoperative pain treatment in these surgeries. Opioids may have adverse effects that may require attention. There are few clinical studies that present the adverse effects of these analgesics in canine postoperative period. The aim of this retrospective study was to present the adverse effects of morphine, methadone and tramadol in canine vertebral surgery postoperative period. There were revised the postoperative records of 180 dogs and the changes resulted from the opioids use were noted. The adverse effects observed were anorexia, hyporexia, vomiting, vocalization, bradycardia, hypothermia, panting, sedation. Pain was also observed in some dogs. A significant difference was found in anorexia between dogs treated with morphine and tramadol and methadone and tramadol. Significant difference was also found in pain between dogs treated with morphine and tramadol. The association of metamizole and morphine or metamizole and methadone was not different in relation to the adverse effects. There was also no difference with the dosage variation and the adverse effects. In conclusion, morphine, methadone and tramadol have adverse effects when used for pain control in the postoperative period of dogs submitted to vertebral surgery. Anorexia, hypophagia and emesis were frequent the adverse effects observed with morphine and methadone and, despite tramadol presented less adverse effects, its use may be not beneficial in the studied doses when we consider the degree of pain, however more controlled studies with clinical situation are needed to confirm this.(AU)

Efeitos adversos da morfina, metadona e tramadol no pós-operatório de cães submetidos à cirurgia da coluna vertebral: 180 casos (2011-2016)

ABSTRACT: Postoperative pain in dogs undergone vertebral surgery is classified as severe and its important an adequate approach to it, because it can influence recovery time, quality of life and surgery outcome. Opioids are indicated for postoperative pain treatment in these surgeries. Opioids may have adverse effects that may require attention. There are few clinical studies that present the adverse effects of these analgesics in canine postoperative period. The aim of this retrospective study was to present the adverse effects of morphine, methadone and tramadol in canine vertebral surgery postoperative period. There were revised the postoperative records of 180 dogs and the changes resulted from the opioids use were noted. The adverse effects observed were anorexia, hyporexia, vomiting, vocalization, bradycardia, hypothermia, panting, sedation. Pain was also observed in some dogs. A significant difference was found in anorexia between dogs treated with morphine and tramadol and methadone and tramadol. Significant difference was also found in pain between dogs treated with morphine and tramadol. The association of metamizole and morphine or metamizole and methadone was not different in relation to the adverse effects. There was also no difference with the dosage variation and the adverse effects. In conclusion, morphine, methadone and tramadol have adverse effects when used for pain control in the postoperative period of dogs submitted to vertebral surgery. Anorexia, hypophagia and emesis were frequent the adverse effects observed with morphine and methadone and, despite tramadol presented less adverse effects, its use may be not beneficial in the studied doses when we consider the degree of pain, however more controlled studies with clinical situation are needed to confirm this.

RESUMO: A dor pós-operatória em cães que são submetidos a cirurgias da coluna vertebral é considerada severa e seu manejo inadequado pode influenciar no tempo de recuperação do paciente, na qualidade de vida e no resultado cirúrgico. Dentre os analgésicos indicados para uso no pós-operatório dessas cirurgias tem-se os opioides, que podem apresentar inúmeros efeitos adversos que requerem atenção. Devido à escassez de estudos clínicos acerca desse assunto em se tratando do pós-operatório de cães, objetivou-se com o presente estudo retrospectivo apresentar os efeitos adversos da morfina, metadona e tramadol utilizados no pós-operatório de cirurgias da coluna vertebral. Foram revisadas e avaliadas as fichas de 180 cães e anotadas as alterações observadas no pós-operatório e decorrentes do uso de opioides. Os principais efeitos adversos observados foram anorexia, hiporexia, vômito, salivação, vocalização, bradicardia, hipotermia, ofegação e sedação. Também foi observada persistência da dor em alguns cães mesmo com o uso de analgésicos. Houve diferença na ocorrência de anorexia nos cães tratados com morfina e nos tratados com metadona em relação aos tratados com tramadol. Ocorreu diferença também entre a observação de dor dos grupos morfina e tramadol. A associação de dipirona com morfina e com metadona não revelou diferença com relação à ocorrência de efeitos adversos, bem como a variação de doses. Conclui-se que a morfina, a metadona e o tramadol apresentam efeitos adversos quando empregados para tratamento da dor pós-operatória em cães submetidos à cirurgia da coluna vertebral; a anorexia, a hiporexia e o vômito foram os efeitos adversos frequentes com o uso de morfina e de metadona e, mesmo que o tramadol apresente menor ocorrência desses efeitos, seu uso, na dose estudada, pode não ser vantajoso quando se leva em consideração o grau de dor para cirurgias da coluna vertebral.

Avaliação metabólica e hemodinâmica de dois protocolos de sedação prolongada em cães / Metabolic and hemodynamic evaluation of two long term sedation protocols in dogs

Objetivou-se determinar a viabilidade de dois protocolos de sedação para ventilação prolongada em cães e seus efeitos hemodinâmicos e metabólicos. Doze cães, alocados aleatoriamente em dois grupos (n=6), receberam infusão contínua de midazolam (0,5mg/kg/h), fentanil (10µg/kg/h) e propofol (18mg/kg/h) no GMF ou cetamina (0,6mg/kg/h), morfina (0,26mg/kg/h) e propofol (18mg/kg/h) no GCM, durante 24 horas. Os cães foram ventilados mecanicamente com FiO2 de 40%, mantendo-se a normocapnia. A FC diminuiu 32% no GMF e 34% no GCM ao longo do tempo, reduzindo o IC em 24% no GMF e em 29% no GCM. A CaO2, o CvmO2, a DO2 e o VO2 diminuíram no GCM (5%, 16%, 31% e 7%) e no GMF (4%, 19%, 26% e 15%), respectivamente. A TEO2 aumentou 32% no GMF e 36% no GCM, sem diferenças entre grupos, porém a calorimetria indireta demonstrou diminuição do VO2, minimizando a redução da DO2. Não houve diferença entre os tempos para extubação, deambulação e recuperação total, com médias globais (minutos) de 33,8±15,9, 134,8±60,7 e 208±77,5, respectivamente. Conclui-se que ambos os protocolos permitiram a ventilação mecânica, com redução do IC e da DO2, porém sem prejuízos hemodinâmicos e metabólicos, podendo ser utilizados com segurança em cães hígidos.

We aimed to determine the hemodynamic and metabolic parameters of two sedative protocols for long-term ventilation in dogs. Twelve dogs, were randomly allocated in two groups (n=6) who received constant rate infusion (CRI) of midazolam (0,5mg/kg/h), fentanyl (10µg/kg/h) and propofol (18mg/kg/h) in GMF or ketamine (0,6 mg/kg/h), morphine (0,26mg/kg/h) and propofol (18mg/kg/h) in GCM, during 24 hours. The dogs were mechanically ventilated to normocapnia with FiO2 of 40%. Heart rate decreased 32% in GMF and 34% in GCM during infusion time reducing CI in 24% at GMF and 29% at GCM. CaO2, CmvO2, DO2 and VO2 decreased in GCM (5%, 16%, 31% and 7% respectively) and GMF (4%, 19%, 26% and 15% respectively). Extraction ratio increased 32% in GMF and 36% in GCM without differences between groups; however, decreased VO2, evaluated for indirect calorimetry, suggests minimization of DO2 reduction. No differences between time to extubation, sternal recumbency and total recovery time were observed between groups, with an average of 33,8±15,9, 134,8±60,7 e 208±77,5 minutes respectively. We conclude that both protocols allowed mechanical ventilation with IC and DO2 reduction without metabolic and hemodynamic impairment, and can be safely used in healthy dogs.

Avaliação metabólica e hemodinâmica de dois protocolos de sedação prolongada em cães / Metabolic and hemodynamic evaluation of two long term sedation protocols in dogs

Objetivou-se determinar a viabilidade de dois protocolos de sedação para ventilação prolongada em cães e seus efeitos hemodinâmicos e metabólicos. Doze cães, alocados aleatoriamente em dois grupos (n=6), receberam infusão contínua de midazolam (0,5mg/kg/h), fentanil (10µg/kg/h) e propofol (18mg/kg/h) no GMF ou cetamina (0,6mg/kg/h), morfina (0,26mg/kg/h) e propofol (18mg/kg/h) no GCM, durante 24 horas. Os cães foram ventilados mecanicamente com FiO2 de 40%, mantendo-se a normocapnia. A FC diminuiu 32% no GMF e 34% no GCM ao longo do tempo, reduzindo o IC em 24% no GMF e em 29% no GCM. A CaO2, o CvmO2, a DO2 e o VO2 diminuíram no GCM (5%, 16%, 31% e 7%) e no GMF (4%, 19%, 26% e 15%), respectivamente. A TEO2 aumentou 32% no GMF e 36% no GCM, sem diferenças entre grupos, porém a calorimetria indireta demonstrou diminuição do VO2, minimizando a redução da DO2. Não houve diferença entre os tempos para extubação, deambulação e recuperação total, com médias globais (minutos) de 33,8±15,9, 134,8±60,7 e 208±77,5, respectivamente. Conclui-se que ambos os protocolos permitiram a ventilação mecânica, com redução do IC e da DO2, porém sem prejuízos hemodinâmicos e metabólicos, podendo ser utilizados com segurança em cães hígidos.(AU)

We aimed to determine the hemodynamic and metabolic parameters of two sedative protocols for long-term ventilation in dogs. Twelve dogs, were randomly allocated in two groups (n=6) who received constant rate infusion (CRI) of midazolam (0,5mg/kg/h), fentanyl (10µg/kg/h) and propofol (18mg/kg/h) in GMF or ketamine (0,6 mg/kg/h), morphine (0,26mg/kg/h) and propofol (18mg/kg/h) in GCM, during 24 hours. The dogs were mechanically ventilated to normocapnia with FiO2 of 40%. Heart rate decreased 32% in GMF and 34% in GCM during infusion time reducing CI in 24% at GMF and 29% at GCM. CaO2, CmvO2, DO2 and VO2 decreased in GCM (5%, 16%, 31% and 7% respectively) and GMF (4%, 19%, 26% and 15% respectively). Extraction ratio increased 32% in GMF and 36% in GCM without differences between groups; however, decreased VO2, evaluated for indirect calorimetry, suggests minimization of DO2 reduction. No differences between time to extubation, sternal recumbency and total recovery time were observed between groups, with an average of 33,8±15,9, 134,8±60,7 e 208±77,5 minutes respectively. We conclude that both protocols allowed mechanical ventilation with IC and DO2 reduction without metabolic and hemodynamic impairment, and can be safely used in healthy dogs.(AU)