Bloqueio do plexo braquial guiado por neuroestimulação elétrica em jabuti piranga (Chelonoidis carbonarius) submetido à intervenção cirúrgica em membro torácico: Relato de caso / Brachial plexus block guided by electrical neurostimulation in a tortoise (Chelonoidis carbonarius) undergoing surgical intervention in the forelimb: Case report

A anestesia local tem sido recomendada para intervenções cirúrgicas quando se procura evitar a anestesia geral do animal com o intuito de minimizar os riscos, que podem ocorrer durante o aprofundamento do plano anestésico, além de promover uma rápida recuperação. O presente trabalho descreve o caso de um jabuti piranga (C. carbonarius) submetido à contenção química associada a bloqueio anestésico em plexo braquial para realização da excisão cirúrgica de um abcesso em membro tórácico direito, sendo apresentadas considerações sobre a aplicabilidade desta técnica em quelônios com destaque para os cuidados a serem tomados pelo anestesista durante a intervenção.(AU)

Local anesthesia has been recommended for surgical interventions when trying to avoid the need of general anesthesia of the animal and to minimize any risks that may occur during the deepening of the anesthetic plane, in addition to promoting a quick recovery. The present work describes the case of a tortoise (C. carbonarius) submitted to chemical restraint associated whit anesthesic blockage in the brachial plexus during surgical intervention to remove an abscess in the right thoracic limb, presenting considerations about the applicability of this technique in chelonians, with emphasis on the care to be taken by the anesthesiologist during the intervention.(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calf’s forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calfs forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...(AU)

Bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba): relato de caso / Brachial plexus block in a red howler monkey (Alouatta guariba): case report

Os bloqueios regionais vêm sendo explorados e difundidos no dia a dia da medicina veterinária. O presente trabalho relata a execução do bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba) submetido à amputação de três dígitos. Foi utilizada ropivacaína para o bloqueio, com o paciente sob anestesia geral, com auxílio de neuroestimulador periférico. Quatro horas após a cirurgia e cinco horas após o bloqueio, o paciente não apresentava desconforto ou evitava a manipulação do membro operado e não foram observadas complicações. O bloqueio do plexo braquial é mais comumente utilizado quando se pretende promover analgesia e relaxamento muscular do membro torácico em procedimentos cirúrgicos distais à articulação escápulo-umeral. Há carência em estudos anatômicos sobre diversos primatas, incluindo o bugio-ruivo (Alouatta guariba). Apesar da crescente expansão da clínica de animais silvestres, ainda há lacunas no que diz respeito à execução de técnicas anestésicas em diversas espécies.(AU)

The regional blocks are being exploited and disseminated on a daily basis of veterinary medicine. This study describes the implementation of the brachial plexus block in a red howler-monkey (Alouatta guariba) that underwent amputation of three digits. Ropivacaine was employed for blocking, with the patient under general anesthesia, with the aid of a peripheral nerve stimulator. Four hours after surgery, and five hours after the blockade, the patient had no discomfort nor avoided manipulation of the operated limb and no complications were observed. The brachial plexus block is most commonly used when you want to promote analgesia and muscle relaxation of the forelimb in distal surgical procedures to the scapular-humeral joint. There is a lack of anatomical studies on various primates, including the red howler-monkey (Alouatta guariba). Despite the growing expansion of clinic of wild animals, there are still shortcomings with regards to the implementation of anesthetic techniques in many species.(AU)

Bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba): relato de caso / Brachial plexus block in a red howler monkey (Alouatta guariba): case report

Os bloqueios regionais vêm sendo explorados e difundidos no dia a dia da medicina veterinária. O presente trabalho relata a execução do bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba) submetido à amputação de três dígitos. Foi utilizada ropivacaína para o bloqueio, com o paciente sob anestesia geral, com auxílio de neuroestimulador periférico. Quatro horas após a cirurgia e cinco horas após o bloqueio, o paciente não apresentava desconforto ou evitava a manipulação do membro operado e não foram observadas complicações. O bloqueio do plexo braquial é mais comumente utilizado quando se pretende promover analgesia e relaxamento muscular do membro torácico em procedimentos cirúrgicos distais à articulação escápulo-umeral. Há carência em estudos anatômicos sobre diversos primatas, incluindo o bugio-ruivo (Alouatta guariba). Apesar da crescente expansão da clínica de animais silvestres, ainda há lacunas no que diz respeito à execução de técnicas anestésicas em diversas espécies.(AU)

The regional blocks are being exploited and disseminated on a daily basis of veterinary medicine. This study describes the implementation of the brachial plexus block in a red howler-monkey (Alouatta guariba) that underwent amputation of three digits. Ropivacaine was employed for blocking, with the patient under general anesthesia, with the aid of a peripheral nerve stimulator. Four hours after surgery, and five hours after the blockade, the patient had no discomfort nor avoided manipulation of the operated limb and no complications were observed. The brachial plexus block is most commonly used when you want to promote analgesia and muscle relaxation of the forelimb in distal surgical procedures to the scapular-humeral joint. There is a lack of anatomical studies on various primates, including the red howler-monkey (Alouatta guariba). Despite the growing expansion of clinic of wild animals, there are still shortcomings with regards to the implementation of anesthetic techniques in many species.(AU)

Anatomic bases for brachial plexus block of capuching (Sapajus libidinosus) / Bases anatômicas para o bloqueio anestésico do plexo braquial de macacos-prego (Sapajus libidinosus)

Background: In captivity, capuchin monkeys compete for space and rank. Fights can result in traumas, especially to the limbs, requiring interventions that are often outpatient. Local anesthesia as a tool in these procedures, as an aid to chemical restraint, is very relevant for small outpatient surgeries, or even for pain relief. Knowledge of peripheral nerve anatomy is essential to perform local anesthesia. Thus the objective of the present study was to determine, by anatomical studies of the brachial plexus region, the best access pathways for anesthetic blocking of the nerve. Materials, Methods & Results: Seven adult capuchin monkeys (Sapajus libidinosus) were used, weighing 2-3 kg, fixed and preserved in formaldehyde aqueous solution at 10%. In five of these animals the supraclavicular, infraclavicular and axillar regions were dissected to visualize the muscles, clavicle and bracchial plexus nerves. An analogical pachymeter was used to measure the depth of the plexus in relation to the cranial and caudal clavicle face and axillary fossa, comparing the length of two hypodermic needles (13x4.5 mm and 15x5 mm). Simulation of the anesthetic block was tested in two animals: before dissecting an acrylic varnish solution was injected using a syringe and 13x4.5 mm needle in the supraclavicular, infraclavicular regions and axillary fossa. To assess the positioning points of the [...](AU)

Anatomic bases for brachial plexus block of capuching (Sapajus libidinosus) / Bases anatômicas para o bloqueio anestésico do plexo braquial de macacos-prego (Sapajus libidinosus)

Background: In captivity, capuchin monkeys compete for space and rank. Fights can result in traumas, especially to the limbs, requiring interventions that are often outpatient. Local anesthesia as a tool in these procedures, as an aid to chemical restraint, is very relevant for small outpatient surgeries, or even for pain relief. Knowledge of peripheral nerve anatomy is essential to perform local anesthesia. Thus the objective of the present study was to determine, by anatomical studies of the brachial plexus region, the best access pathways for anesthetic blocking of the nerve. Materials, Methods & Results: Seven adult capuchin monkeys (Sapajus libidinosus) were used, weighing 2-3 kg, fixed and preserved in formaldehyde aqueous solution at 10%. In five of these animals the supraclavicular, infraclavicular and axillar regions were dissected to visualize the muscles, clavicle and bracchial plexus nerves. An analogical pachymeter was used to measure the depth of the plexus in relation to the cranial and caudal clavicle face and axillary fossa, comparing the length of two hypodermic needles (13x4.5 mm and 15x5 mm). Simulation of the anesthetic block was tested in two animals: before dissecting an acrylic varnish solution was injected using a syringe and 13x4.5 mm needle in the supraclavicular, infraclavicular regions and axillary fossa. To assess the positioning points of the [...]