Resumo

Background: The Coragyps atratus flies long distances in search of food and has a marked behaviour of food competition. Since they are frequently found in areas of recent human occupation, they are subject to trauma, which may require surgical interventions. Locoregional blocks are used as part of a balanced-anaesthesia protocol and are currently being evaluated in birds, with brachial plexus block being the main technique described in the literature. However, to our knowledge, this is the first description of intravenous regional anaesthesia (Bier's block) in a vulture. Thus, we aim to report the use of Bier's block with 1% lidocaine, in a black-headed vulture submitted to digit amputation. Case: A black-headed vulture (Coragyps atratus), weighing 2 kg, was rescued and referred to the Veterinary Hospital due to its inability to fly. Physical examination revealed a swollen digit in the right pelvic limb. Radiographic examination confirmed the intermediate phalanx fracture of the 4th digit of the right pelvic limb with signs suggestive of advanced osteomyelitis. The animal was referred to surgery for amputation of the affected digit. Before surgery, water and food were withdrawn for 12 h. Pre-anaesthetic medication consisted of 1 mg/kg midazolam and 0.5 mg/kg morphine intramuscularly (IM). Anaesthetic induction was performed through face mask with isoflurane, followed by orotracheal intubation with a 3 mm-endotracheal tube. Anaesthesia was maintained with isoflurane through a non-rebreathing circuit in 100% oxygen. Using a multiparametric monitor, heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ), oxyhemoglobin saturation (SpO2 ), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) were evaluated. Antisepsis of the right pelvic limb was performed and an elastic band was applied around the distal region of the affected tibia to serve as a tourniquet. A scalp vein set was used to access the lateral saphenous vein in the region distal to the tourniquet, and 5 mg/ kg lidocaine 1% was injected intravenously. The patient remained stable during the procedure, with no need for analgesic rescue. The tourniquet was gradually released 40 min past its application, being completely removed after 45 min of surgery. The anaesthetic supply was interrupted, with extubation after 4 min; the patient had satisfactory anaesthetic recovery. Discussion: The present report describes the success in using the technique of intravenous regional anaesthesia with 1% lidocaine for digit amputation performed on a specimen of black-headed vulture. The pre-anaesthetic medication provided analgesia, satisfactory sedation for venoclysis, and anaesthetic induction without complications. Anaesthetic induction and maintenance in birds are preferably performed with inhaled anaesthetics, thus the choice of mask induction. Despite the reduction in RR soon after induction, the patient remained on spontaneous ventilation. Bier's block using 5 mg/kg lidocaine showed to be an easy and safe technique in vultures, but doses up to 6 mg/kg lidocaine are not associated with adverse effects in birds. The intravenous regional anaesthesia technique described in this manuscript promoted adequate analgesia for the digit amputation procedure in black-headed vultures and allowed hemodynamic stability without significant anaesthetic complications. Thus, the present report points to the potential use of this locoregional block in other birds.

Resumo

O presente estudo objetivou avaliar a anestesia raquidiana com ropivacaína em cães alterando a baricidade do anestésico local, investigando as alterações hemodinâmicas e complicações. Foram utilizados seis cães, Beagle, 4 anos, submetidos a anestesia inalatória com isofluorano e aos tratamentos: Ghipo = anestesia raquidiana hipobárica (0,5 mL NaCl 0,9% + 0,5 mL ropivacaína 0,75%); Giso = anestesia raquidiana isobárica (0,5 mL NaCl 1,53% + 0,5 mL ropivacaína 0,75%); Ghiper = anestesia raquidiana hiperbárica (0,5 mL glicose 10% + 0,5 mL ropivacaína 0,75%). Após indução anestésica e manutenção com isofluorano, os animais foram posicionados em decúbito lateral direito para a passagem de um cateter de artéria pulmonar pela veia jugular esquerda. Após esse procedimento, a punção subaracnóide foi realizada entre L5-L6 com uma agulha espinhal 22G, seguida da administração de 1 mL de anestésico local em 1 min. Os animais foram mantidos por 60 minutos anestesiados em decúbito ventral. A FC, f, PAM, DC, PAPm e TºC apresentaram aumento progressivo em todos os grupos enquanto que a PCPm, apenas no GHIPO, aumentou ao longo de todos os momentos. O IRPT no GISO apresentou valores significativamente superiores no M1, M5 e M10 comparado aos demais grupos, exceto no M5, em que o GISO diferiu somente do GHIPER. O IRVP no GISO aumentou no M5 em comparação ao MB. Foram observados efeitos adversos como déficit motor unilateral, atonia vesical, excitação, dor aguda e quemose. De acordo com os dados obtidos no presente estudo pode-se concluir que os animais que receberam anestesia raquidiana com as soluções hiperbárica e isobárica apresentaram maior bloqueio motor comprovando que a baricidade influencia diretamente o tipo de fibra a ser bloqueada. A utilização de solução isobárica resulta em um bloqueio misto (motor e sensitivo). As alterações hemodinâmicas descritas na literatura como, bradicardia e hipotensão, não puderam ser evidenciadas neste estudo embora o volume de anestésico tenha sido baixo associado a influência dos efeitos do isofluorano. Em relação às complicações evidenciadas, sugere-se acompanhamento pós-anestésico dos animais submetidos à anestesia raquidiana a fim de que quaisquer alterações possam ser identificadas precocemente e tratadas.(AU)

The aim of the study was to assess hemodynamic changes and complications of spinal anesthesia with ropivacaine at different baricities. Six beagle dogs aged four years. The dogs were anesthetized with isoflurane and subjected to the following treatments: Ghypo = spinal anesthesia with hypobaric ropivacaine (0.5mL of 0.9% NaCl+0.5mL ropivacaine at 0.75%); Giso = isobaric spinal anesthesia (0.5mL of 0,906% NaCl+0.5mL ropivacaine at 0.75%); Ghyper = hyperbaric spinal anesthesia (0.5mL of 10% glucose+0.5mL ropivacaine at 0.75%). After induction to anesthesia and maintenance with isoflurane, animals were positioned in right lateral recumbency for pulmonary artery catheterization through the left jugular vein. Spinal anesthesia was carried out with injection of 1mL of local anesthetic using a 22G Quincke tip needle in the L5-L6 space along 1 minute. Dogs were maintained under inhalation anesthesia for 60 minutes in ventral recumbency. HR, FR, MAP, CO, mPAP and body temperature progressively increased in all groups, whereas PCWP increased only in GHYPO at all time points. The TPRI showed significantly higher values in GISO at M1, M5 and M10 compared to the other groups, except for M5, during which GISO differed only from GHYPER. The PVRI increased at M5 compared to MB in GISO. Side effects such as unilateral motor deficit, bladder atony, excitation, acute pain and chemosis were observed. The hemodynamic changes were not relevant, although inhalation anesthesia with isoflurane might have influenced the results. The changes observed in the study demonstrate that motor blockade is likely to be obtained with isobaric and hyperbaric ropivacaine, thereby confirming the influence of baricity on the type of nerve fibers on the spinal cord. The isobaric solution results in a mixed blockade (motor and sensory blockade). Hemodynamic changes such as hypotension and bradycardia were not evidenced in this study, although local anesthetics were administered in low volumes and together with isoflurane anesthesia. Regarding complications, post-anesthetic observation is warranted in order to identify and treat possible changes. Spinal anesthesia in the conditions studied did not cause hemodynamic changes in isoflurane-anesthetized dogs and is thus considered safe for routine practice, although a few complications are prone to occur.(AU)

Resumo

The aim of this study was to assess the cardiopulmonary, analgesic, adverse effects, serum concentration of cortisol and plasma levels of levobupivacaine and morphine in bitches undergoing propofol anesthesia and epidural analgesia with levobupivacaine alone or combined with morphine. This was a randomized 'blinded' prospective clinical study using 32 adult bitches weighing 9.8±4.1kg that were admitted for elective ovariohysterectomy. Twenty minutes after administration of acepromazine and midazolam, anesthesia was induced with propofol (4mg kg-1) and maintained by a continuous rate infusion (CRI). Each animal was randomly assigned to one of four epidural groups: GL = levobupivacaine alone (0.33mg kg-1); GLM0.1 = levobupivacaine and morphine (0.1mg kg-1); GLM0.15 = levobupivacaine and morphine (0.15mg kg-1); and GLM0.2 = levobupivacaine and morphine (0.2mg kg-1)...

Objetivou-se avaliar os efeitos cardiovasculares, analgésico, adversos, a concentração sérica de cortisol e os níveis plasmáticos de levobupivacaína e morfina em cadelas submetidas à infusão contínua de propofol e analgesia peridural com levobupivacaína isolada ou associada à morfina. Para tanto, realizou-se um estudo clínico prospectivo randomizado com 32 cadelas adultas pesando 9,8 ± 4,1kg, que foram submetidas à ovário-histerectomia eletiva. Vinte minutos após a administração de acepromazina e midazolam, os animais foram induzidos com propofol (4mg/kg) e mantidos por uma infusão contínua (CRI) do mesmo fármaco. Cada animal foi alocado aleatoriamente em um dos quatro grupos: GL = levobupivacaína isolada (0,33mg/kg); GLM0,1 = levobupivacaína + morfina (0,1mg/kg); GLM0,15 = levobupivacaína + morfina (0,15mg/kg) e GLM0,2 = levobupivacaína + morfina (0,2mg/kg)...

Resumo

são instituídas as manobras de recrutamento alveolar (MRA) através da administração de elevadas pressões no sistema respiratório. Estas manobras quando utilizadas de maneira inadequada podem contribuir para a formação de atelectasias, barotrauma, volutrauma e até mesmo atelectrauma; sendo de suma importância a sua monitoração. Com isso, uma nova técnica, a tomografia por impedância elétrica (TIE), vem sendo estudada, no qual, seu funcionamento se dá por emissão de corrente elétrica de baixa frequência e intensidade nos tecidos, gerando uma imagem dos tecidos avaliados. Sendo assim, o objetivo do presente estudo experimental foi avaliar se na espécie equina a TIE é capaz de visualizar as alterações de volume corrente global e regional, em pulmões saudáveis, durante a ventilação mecânica e escalonamento da PEEP como MRA. Para tanto foram utilizados 14 equinos de peso médio de 306 kg, submetidos a anestesia geral inalatória em decúbito dorsal. Os animais foram mecanicamente ventilados com volume corrente de 14 mL/kg e frequência respiratória de 7-9 mpm. Foi instituída manobra de recrutamento alveolar, aumentando-se a PEEP de 5 em 5 cmH2O, a cada 5 minutos, até 32 cmH2O, seguido de seu decréscimo também de 5 em 5 cmH2O, a cada 5 minutos, até 7 cmH2O. Foram realizadas coletadas de amostras de sangue arterial para hemogasometria, imagens do TIE e registrados os parâmetros hemodinâmicos e de mecânica respiratória em cada estágio do escalonamento da PEEP. Durante a MRA foram observados aumento na PaO2/FiO2 dos pacientes assim como aumento na complacência estática pulmonar, associado a uma diminuição no shunt pulmonar, e deslocamento da ventilação para região pulmonar dependente por meio da TIE, principalmente em PEEP acima de 17 cmH2O. Como efeitos adversos foram observados alterações em parâmetros hemodinâmicos sendo estas transitórias. Portanto o TIE demonstrou-se capaz de avaliar as mudanças de ventilação pulmonar durante a MRA e mostrou relação com os ganhos em oxigenação e mecânica pulmonar.

The main cause of respiratory dysfunction in horses under isoflurane anaesthesia is hypoxemia attributed to the atelectasis formation areas. In order to revert these sets, alveolar recruitment manoeuvres (ARM) are instituted through high pressures administration in the respiratory system. These manoeuvres when used improperly can contribute to the atelectasis formation, barotrauma, volutrauma and even atelectrauma; being of utmost importance its monitoring. A new technique, electrical impedance tomography (EIT), has been studied, in which its operation is due to the low frequency and intensity of electric current emission in the tissues, generating tissues images for evaluation. Therefore, the present experimental study aimed to evaluate whether in horses the EIT is able to visualize changes of global and regional tidal volume in healthy lungs during mechanical ventilation and titration of PEEP as ARM. For this purpose, 14 horses weighting 306 kg were used, undergoing general inhalation anaesthesia in dorsal recumbence. The animals were mechanically ventilated with tidal volume of 14 mL/kg and respiration rate of 7-9 bpm. An alveolar recruitment manoeuvre was instituted, increasing the PEEP by 5 cmH2O every 5 minutes until 32 cmH2O, followed by decreasing it by 5 cmH2O every 5 minutes to 7 cmH2O. Arterial blood samples were collected for hemogasometry, EIT images and hemodynamic parameters and respiratory mechanics were recorded at each stage of PEEP. During ARM, patients' PaO2/FiO2 increased as well as increased pulmonary static compliance, associated with a decrease in pulmonary shunt, and pulmonary ventilation moving to dependent areas, mainly when 17 cmH2O or more were applied. As adverse effects were observed transient changes in hemodynamic parameters. So TIE is capable of presenting the changes in pulmonary ventilation in horse in dorsal recumbency undergoing ARM, and showed good relation to oxygenation gain and respiratory mechanics.

Resumo

A anestesia caudal foi proposta pela primeira vez em 1926 e diversas técnicas foram desenvolvidas para anestesiar os nervos espinhais lombares e sacrais. Os métodos para anestesia epidural exigem conhecimento da anatomia da região envolvida. Desta forma, objetivou-se determinar a topografia do cone medular da preguiça (Bradipus variegatus), para fornecer recursos aos profissionais da área clínica para que, desta forma, seja possível a realização de anestesia epidural nesta espécie silvestre de nossa fauna. Foram dissecados quatro exemplares adultos de preguiça, dois machos e duas fêmeas que foram a óbito por causas naturais e obtidos junto ao Parque Zoobotânico do Museu Paraense Emilio Goeldi, Belém/Pará. Após a dissecação observou-se que o cone medular encontra-se entre as vértebras L3 e S1 com comprimento médio de 2,7cm, e a intumescência lombar apresentou comprimento médio de 1,0cm, estando localizada entre L1 e L3 nos quatro animais estudados. Desta forma, conclui-se que o melhor local para a realização de anestesia epidural na preguiça está entre as vértebras L1 e L3.

Caudal anaesthesia was initially proposed in 1926, since when techniques have been evolved for lumbar and sacral anaesthesia. Essentially, epidural anaesthesia demands regional anatomy knowledge. We aimed to determine medullar conus topography in sloth (Bradipus variegatus), in order to supply information for epidural anaesthesia in this species. Four adult sloths were investigated, two males and two females, that died from natural causes and were donated by the Zoobotanic Park of Emilio Goeldi Museum, Belém/Pará. It was observed that the medullar conus lies between L3 and S1vertebrae, average length measuring 2.7cm, and that the lumbar swelling is located between L1 and L3 with an average length of 1.0cm. We concluded that the most appropriate site to perform epidural anesthesia in sloths is from L1 to L3 vertebral spaces.

Resumo

The regional anaesthesia in the dog, for dental block is studied by the Author. Methods of injections into the pterygo-palatine fossa are described, receiving attention the Tosos technique, with some modifications. Anatomical aspects, instruments and technique applied are present, so the Authors conclusion.

O artigo apresenta resumo em inglês.