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OBJECTIVE: To evaluate cardiopulmonary, arterial blood gas and propofol-sparing effects of magnesium sulfate (MgSO4) constant rate infusion (CRI) in mechanically ventilated dogs maintained under total intravenous anesthesia with propofol. STUDY DESIGN: Blinded, randomized, clinical trial. ANIMALS: A total of 24 healthy adult dogs. METHODS: Dogs were premedicated with intramuscular acepromazine (0.05 mg kg-1) and morphine (0.5 mg kg-1), followed by an intravenous (IV) bolus of saline or MgSO4 (50 mg kg-1 over 15 minutes) and propofol (given to effect to induce anesthesia). Anesthesia was maintained with an IV propofol infusion (beginning at 0.3 mg kg-1 minute-1, adjusted as necessary). Concurrently, one of three IV infusions were administered: GS (0.9% NaCl), GM30 (MgSO4, 30 mg kg-1 hour-1) or GM80 (MgSO4, 80 mg kg-1 hour-1). Propofol induction and maintenance doses were recorded. The following variables were recorded at baseline (T0), after bolus treatment (T1), after beginning mechanical ventilation (T5) and every 15 minutes until the end of the procedure (T15-T120): mean arterial pressure, heart rate, peripheral oxygen saturation, end-tidal partial pressure of CO2, temperature, blood gas variables, indirect calorimetry and extubation time. Values of p < 0.05 were considered significant. RESULTS: Propofol induction bolus dose was lower in GM30 (31.2%, p = 0.04) and GM80 (38.9%, p = 0.003) than in GS. The maintenance propofol infusion rate in GM80 was 16.9% lower (p = 0.03), resulting in fewer propofol CRI rescues during the perioperative period. GM30 and GM80 exhibited faster extubation times than GS (46.2%, p = 0.002 and 48.9%, p = 0.001, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: Infusion of a 50 mg kg-1 bolus, followed by CRI of MgSO4 (30 and 80 mg kg-1 hour-1), reduces the propofol induction and maintenance (CRI) requirement, maintaining cardiorespiratory stability and reducing the time required to extubation.
RESUMO
OBJECTIVE: To evaluate the onset and duration of hematological changes and the use of Doppler ultrasound (spleen) in dogs sedated with acepromazine or xylazine. STUDY DESIGN: Clinical study. ANIMALS: A total of 24 mixed breed dogs aged 1-4 years and weighing 15-25 kg. METHODS: Dogs were randomly distributed into two groups: acepromazine group (AG) which were administered acepromazine (0.05 mg kg-1) intramuscularly and xylazine group (XG) administered xylazine (0.5 mg kg-1) intramuscularly. Sonographic evaluations (morphologic and hemodynamic splenic vascularization) and hematologic tests were performed before drug administration (baseline) and 5, 15, 30, 60, 120, 240, 360, 480 and 720 minutes after drug administration. RESULTS: A significant reduction occurred in erythrogram variables in AG at 15-720 minutes corresponding with a significant enlargement of the spleen. In XG, a significant reduction was observed in the erythrogram variables at 30-60 minutes without a significant enlargement of the spleen. Hilar diameter did not change over time in either group. Flow alterations were found only in the splenic artery in AG, with a decreased final diastolic velocity observed at 60-120 minutes. CONCLUSIONS: Administration of acepromazine resulted in decreased red blood cell count, hemoglobin, packed cell volume and an increased diameter of the spleen. Xylazine administration resulted in similar hematologic changes but of smaller magnitude and duration and without splenic changes. The absence of significant changes in the Doppler flow parameters of the splenic artery and vein and the hilar diameter suggests that the splenomegaly that was observed in AG was not due to splenic vasodilation. No splenic sequestration occurred after xylazine administration. CLINICAL RELEVANCE: The results indicate that acepromazine decreases the erythrocyte concentrations by splenic erythrocyte sequestration and concomitant splenomegaly. Xylazine can cause slight hematologic changes, but without splenic changes.
Assuntos
Acepromazina , Hipnóticos e Sedativos , Baço/efeitos dos fármacos , Xilazina , Acepromazina/administração & dosagem , Acepromazina/efeitos adversos , Acepromazina/farmacologia , Animais , Sedação Profunda/efeitos adversos , Sedação Profunda/métodos , Sedação Profunda/veterinária , Cães , Contagem de Eritrócitos/veterinária , Feminino , Hematócrito/veterinária , Hemoglobinas/análise , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/efeitos adversos , Hipnóticos e Sedativos/farmacologia , Injeções Intramusculares/veterinária , Masculino , Baço/irrigação sanguínea , Baço/diagnóstico por imagem , Ultrassonografia Doppler/veterinária , Xilazina/administração & dosagem , Xilazina/efeitos adversos , Xilazina/farmacologiaRESUMO
Parenteral nutrition (PN) is commonly used in intensive care units (ICUs) and is associated with earlier hospital outcome. However, there is scarcity of information about the metabolic effects of PN caloric distribution for dogs. Considering the high tolerance of dogs to lipids and, also, that hospitalized animals usually present insulin resistance, PN formulation with high fat instead high glucose can provide metabolic benefits in this specie. This study evaluated two PN protocols, based on high lipid or high carbohydrate in 12 healthy dogs under sedation/ventilation during 24 h. For baseline data, blood samples were collected 24 h before the study beginning. After fasting, the dogs were anesthetized and put under mechanical ventilation without energy support for 12 h to obtain: daily energy expenditure (DEE), respiratory quotient (RQ), oxygen consumption (VO2), carbon dioxide production (VCO2), lactate, glucose, cholesterol, and triglycerides concentrations. After, the dogs were allocated into two groups: lipid-based energy group (LEG) and carbohydrate-based energy group (CEG). Both groups received the PN infusions at a rate of 3 mL/kg/h for 12 h. Blood tests were performed 12, 24, and 48 h after infusion's completion. VO2 increased after PN in LEG, increasing energy expenditure compared to CEG. RQ remained close to 1 in CEG, indicating carbohydrate preferential consumption. Triglycerides increased in both groups after propofol infusion, remaining higher in LEG until the end of the evaluation. Glycaemia increased in CEG compared to baseline. In conclusion, both PN protocols can be used in healthy animals undergoing prolonged sedation protocols. However, high lipid PN had higher VO2 and DEE, and resulted in higher triglycerides concentrations and lower glycaemia indexes than carbohydrate, making high carbohydrate PN preferable to high lipid PN. Therefore, for use in critically ill patients, the data obtained in this study should be extrapolated, taking into consideration the specificity of each case.
Assuntos
Consumo de Oxigênio , Nutrição Parenteral , Humanos , Cães , Animais , Nutrição Parenteral/veterinária , Glucose/metabolismo , Respiração Artificial/veterinária , TriglicerídeosRESUMO
ABSTRACT: The objective of this study was to investigate the echocardiographic changes during anesthesia induction in dogs sedated with acepromazine (0.05mg/kg) and butorphanol (0.3mg/kg) (AB). Twenty-four male dogs, with a mean weight of 12.40kg±3.1kg, were randomly assigned to 4 groups (n=6). Fifteen minutes after administering pre-anesthetic medication, anesthesia with diazepam (0.5mg/kg) and etomidate (1mg/kg) (group DE); diazepam (0.5mg/kg) and ketamine (3mg/kg) (group CD); propofol (4mg/kg) (group P); or ketamine (1mg/kg) and propofol (3mg/kg) (group CP) was administered to the 6 dogs in each group. Systolic blood pressure (SBP) was measured and echocardiography was performed immediately prior to the application of the sedation protocol (baseline), 15 minutes after sedation (M1), and immediately after anesthesia induction (M2). No significant differences were observed in SBP and in hemodynamic variables such as cardiac index, shortening fraction, and ejection fraction, between groups at all time points (M0, M1, and M2) evaluated. The SBP was significantly reduced after anesthetic induction in the dogs of the DE and CP groups. It can be concluded that the protocols DE and CP reduce similarly to SPB in dogs medicated with CD and P to SBP remain stable after anesthetic induction. All anesthetic induction protocols maintained a stable IC in premedicated dogs. None of the protocols evaluated promoted significant echocardiographic changes. Furthermore, the ketamine and diazepam combination had a negative impact on myocardial relaxation.
RESUMO: O aumento crescente da expectativa de vida dos cães, faz com que muitos animais cardiopatas necessitem de um procedimento anestésico-cirúrgico. Os objetivos do estudo foram investigar as alterações ecocardiográficas de protocolos de indução anestésica, em cães sedados com acepromazina (0,05mg/kg) e butorfanol (0,3mg/kg) (AB). Foram utilizados 24 cães, machos, SRD, com peso médio de 12,40±3,1kg, os quais foram alocados aleatoriamente em quatro grupos (n=6). Após 15 minutos da medicação pré-anestésica, foi realizada indução anestésica com diazepam (0,5mg/kg)/etomidato (1mg/kg) (DE), ou diazepam (0,5mg/kg)/cetamina (3mg/kg) (CD), oupropofol (4mg/kg) (P) ou cetamina (1mg/kg)/propofol (3mg/kg) (CP). Aferiu-se a PAS e ecocardiografia imediatamente antes da aplicação do protocolo de sedação (basal), 15 minutos após a sedação (M1) e imediatamente após a indução anestésica (M2). Não foram observadas diferenças significativas na PAS e nas variáveis hemodinâmicas como índice cardíaco, fração de encurtamento, fração de ejeção, entre os grupos, em todos os momentos avaliados. A PAS reduziu significativamente, após indução anestésica, nos cães do grupo DE e CP. A FC reduziu, após indução, em relação aos valores pós sedação, somente no grupo CD, mantendo-se estável nos demais grupos estudados. Conclui-se que os protocolos DE e CP reduzem de maneira semelhante a PAS, nos cães medicados com CD e P a PAS mantêm-se estável, após indução anestésica. Todos os protocolos de indução anestésica mantém estáveis o IC em cães pré-medicados. Nenhum dos protocolos avaliados promove alterações ecocardiográficas significativas. Aassociação cetamina/diazepam tem um impacto negativo no relaxamento miocárdico.
RESUMO
O objetivo deste estudo foi avaliar a utilização de dreno de sucção fechado em feridas cirúrgicas de mastectomias unilaterais totais em cadelas. Foram utilizadas 18 cadelas com peso médio de 14,87±9,29kg, idade média 9,34±2,68 anos, provenientes da rotina hospitalar, as quais foram selecionadas por meio de avaliação clínica e oncológica. Os animais foram alocados em dois grupos: Convencional (GC, n=9) que foram submetidas à cirurgia de mastectomia unilateral total, sem colocação de dreno e grupo Dreno (GD, n=9) que foram submetidas à mastectomia unilateral total com colocação do dreno de sucção fechado (Biovácuo?), sendo o diâmetro do dreno determinado conforme peso do animal. Foram realizadas cinco avaliações durante o período pós-operatório: avaliação clínica diária dos animais através da frequência cardíaca (FC), frequência respiratória (f), temperatura retal (TR), coloração de mucosas, tempo de preenchimento capilar (TPC), grau de desidratação, hemograma, perfil bioquímico (ureia, creatinina, colesterol, triglicérides e glicose); avaliação qualitativa do dreno; avaliação qualitativa da ferida cirúrgica, sendo esta também realizada em 14 e 30 dias quanto à presença ou não de exsudato, edema, integridade da pele, deiscência, necrose e fibrose cicatricial; avaliação quantitativa do fluido drenado e avaliação qualitativa do fluido drenado, quanto à celularidade, tipo e morfologia celular. Houve aumento dos valores médios de densidade, neutrófilos, linfócitos, e aumento do valor de mediana de fibrinogênio do fluido drenado em 72 horas em relação às 24 horas no grupo GD. Ocorreu aumento do exsudato em 24, 48 e 72 horas no GD quando comparado ao GC. Houve aumento do volume de fluido drenado em 60 e 72 horas em relação às 12 horas no grupo GD. Houve redução do valor médio de eritrócitos em 72 horas em relação ao basal no grupo GD. Observou-se aumento nos valores médios de hemoglobina e hematócrito em 24 horas no grupo GC quando comparado ao GD. Houve aumento no valor médio de neutrófilos segmentados no basal no GD quando comparado ao GC. Conclui-se que a técnica de colocação de dreno de sucção fechado apresenta maior teor de exsudato. Recomenda-se que o vácuo do dreno seja refeito de 12 em 12 horas, sendo inicialmentrealizado 6 horas após o término da cirurgia. O dreno de sucção fechado não gera desconforto adicional ao paciente; recomenda-se que o mesmo seja removido 72 horas após o término da cirurgia, quando a produção de fluido diminui, porém mesmo assim alguns indivíduos podem apresentar formação de seroma no pós-operatório tardio.(AU)
The aim of this study was to evaluate the use of closed suction drain in surgical wounds of total unilateral mastectomy in dogs. Eighteen dogs were used with an average weight of 14.87±9.29kg, average age 9.34±2.68 years, from the hospital routine, which were selected through clinical and oncological evaluation. The animals were divided into two groups: Conventional (CG, n=9) which underwent total unilateral mastectomy surgery without drain and Drain group (DG, n=9) which underwent complete unilateral mastectomy with placement closed suction drain (Biovácuo?). The diameter of the drain was determined according to the animal weight. Five evaluations were performed during the postoperative period: clinical evaluation of the animals daily through the heart rate (HR), respiratory rate (RR), rectal temperature (RT), color of mucous membranes, capillary refill time (CRT), degree of dehydration, blood count, chemistry profile (urea, creatinine, cholesterol, triglycerides and glucose); qualitative assessment of the drain; qualitative assessment of the surgical wound, is also being held on 14 and 30 days for the presence or absence of exudate, edema, skin integrity, dehiscence, necrosis and scarring; quantitative evaluation of the drained fluid; qualitative assessment of fluid drained, as the cellularity type and cell morphology. Surgical time was recorded in both groups. There were an increase in average values of density, neutrophils, lymphocytes, and increased fibrinogen median value of drained fluid in 72 hours compared to 24 hours in DG group. There was an increase of exudate within 24, 48 and 72 hours in DG when compared to GC. There was an increase in the volume of drained fluid in 60 and 72 hours compared to 12 hours in DG. There was a reduction in the average value of red blood cells within 72 hours from baseline in DG group. There was an increase in average hemoglobin and hematocrit in 24 hours in the control group compared to the DG. There was an increase in the average value of neutrophils targeted at baseline in DG when compared to CG. It follows that, the closed suction drain placement technique presents more exudate. It is recommended that the drain vacuum is redone 12 in 12 hours, initially being performed 6 hours after surgery. The closed suction drain does not generate additional discomfort to the patient; it is recommended that it be removed 72 hours after the surgery, when the fluid production decreases, but even so some individuals may present seroma formation in the late postoperative.(AU)
Assuntos
Animais , Feminino , Cães , Drenagem/tendências , Canal de Drenagem do Solo , Cães/anormalidades , Cães/cirurgia , Mastectomia/estatística & dados numéricosRESUMO
O tramadol é um fármaco opioide amplamente utilizado em medicina veterinária, porém seu uso e eficácia analgésica pós-cirúrgica não foi investigado em aves. Objetivou-se avaliar a eficácia do tramadol ou butorfanol em galos submetidos à ostessíntese de úmero. Foram utilizados 12 galos (Gallus gallus domesticus), os quais foram alocados aleatoriamente em dois grupos: grupo tramadol (GT) que recebeu como medicação pré anestésica (MPA) 5mg.Kg-1 de tramadol e o grupo butorfanol (GB) que recebeu como MPA 1mg.kg-1 de butorfanol, ambos pela via intramuscular. Em seguida a indução ocorreu com a administração do agente anestésico inalatório, isoflurano 3V% e a manutenção anestésica com o mesmo agente 1,3 V%. Avaliaram-se a pressão arterial sistólica (PAS), frequência cardíaca (FC), frequência respiratória (f) e temperatura corporal (TC). As avaliações foram realizadas: antes da MPA (M0); 15 minutos após MPA (M1); após indução anestésica (M2) e em diferentes momentos cirúrgicos (M3, M4, M5 e M6). A analgesia pós-operatória foi avaliada através da escala adaptada de dor em aves por dois avaliadores cegos aos tratamentos nos momentos: basal, e 1, 2, 4, 6, 8, 10, 12 e 24 horas pós-operatórias; sendo o resgate analgésico realizado quando uma pontuação maior ou igual a seis pontos de um total de 24 fosse observada. Observou-se redução da FC, f e da TC entre os momentos M2 e M6 em relação ao momento basal em ambos os grupos, sendo que no GB períodos de apneia foram observados entre M2 e M6, e entre grupos valores maiores na f no GT foram observados no momento M5 em relação ao GB. Houve diminuição da PAS apenas no momento M3 em relação ao momento basal no grupo GT. No pós-operatório apenas um animal do GT necessitou resgate analgésico observando-se pontuação maior no GT entre M1 e M8 e no GB entre M1 e M12 em relação ao momento basal, e entre grupos apenas T12 foi maior em GB quando comparado ao GT. Através da utilização da escala de dor em pombos submetidos à osteossíntese em membro pélvico e adaptada para avaliação álgica em galos, conclui-se que o tramadol e o butorfanol podem ser utilizados como analgésicos eficientes para o controle de dor pós-operatória em galos.(AU)
Tramadol is an opioid drug widely used in veterinary medicine, but their use and postoperative analgesic efficacy has not been investigated in birds. This study aimed to evaluate the efficacy of tramadol or butorphanol roosters submitted to osteosynthesis of humerus. Twelve roosters (Gallus gallus domesticus) randomly into two groups were used: Tramadol group (TG) received as premedication 5mg.kg-1 of tramadol and butorphanol group (GB) as premedicated with 1mg.kg-1 of butorphanol. Then the induction occurred with the administration of inhalational anesthetic, isoflurane 3V% and anesthetic maintenance with the same agent 1.3V%. We evaluated systolic blood pressure (SBP), heart rate (HR), respiratory rate (RR) and body temperature (BT). The evaluations were performed: before MPA (M0); 15 minutes after MPA (M1); after induction (M2) and different surgical times (M3, M4, M5 and M6). Postoperative analgesia was assessed by the modified scale of pain in birds by 2 reviewers blinded to the treatments in times: baseline and 1, 2, 4, 6, 8, 10, 12 and 24 hours postoperatively; being the analgesic rescue perfomed when a higher sore than or equal to six points of a total of 24 were observed. Observed reduction in HR, RR and BT between M2 and M6 moments compared to baseline in both groups, and in GB periods of apnea were observed between M2 and M6, and between groups at higher values f in GT were M5 observed when compared to GB. SBP decreased only when M3 relative to baseline in the TG group. Postoperatively only a GT animal needed analgesic rescue with a higher score on the GT between M1 and M8 and GB between M1 and M12 compared to baseline, and between groups only T12 was higher in GB when compared to the GT. It was concluded that through the evaluation scale used analgesic, butorphanol, and tramadol showed satisfactory analgesia and may be used to control pain roosters subjected to fixation of the humerus.(AU)