Avaliação da analgesia pós-operatória da dexmedetomidina isolada e associada à morfina quando utilizada na medicação pré-anestésica em cadelas submetidas à ovariosalpingohisterectomia eletiva / Evaluation of postoperative analgesia of dexmedetomidine alone or associated to morphine as premedicants in bitches undergoing ovariosalpingohisterectomy

Background: Elective ovariossalpingohysterectomy is a common surgery that causes mild to moderate pain. Aiming at the treatment of pain in these patients, analgesia should be balanced from pre-anesthetic, transoperative and postoperative medication, with-2-agonists and opioids being commonly used, especially dexmedetomidine that has sedation, relaxation muscle and analgesia.The aim of the present study was to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and associated withmorphine when used in the preanesthetic medication of bitches submitted to elective ovarian oysterectomy using the modifiedGlasgow pain scale and the Melbourne pain scale.Materials, Methods & Results: Twenty bitches were used in this study, all of them submitted to ovarian oysterectomy, and were clinically healthy according to laboratory and clinical exams. During the experiment, bitches were randomly distributed into two groups,which received preanesthetic medication (MPA) with 5 μg/kg dexmedetomidine alone (GD) or associated with 0.3 mg/kg morphine(GDM) intramuscularly (IM). In both groups, anesthetic induction with dose-effect propofol was performed and maintained withisoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the weightof the animal and maintained on spontaneous ventilation. After stabilization of the patient the surgery was started, which lasted 45min. The bitches were evaluated by the Modified Glasgow Scale (GSM), the Melbourne Scale (MS) and the Dobbins Sedation Scale(DS), previously administered MPA (T0) and the others performed in 1h (T1), 2h (T2), 4h (T3), 8h (T4), 12h (T5) and 24h (T6) afterextubation. If the GSM score was greater than the value of 3.3 an analgesic rescue of 0.5 mg/kg of morphine intramuscularly would beadministered. An increase in the scoring of pain scales in both groups can be observed from the T1, with significant difference only ofthe...

Avaliação da analgesia pós-operatória da dexmedetomidina isolada e associada à morfina quando utilizada na medicação pré-anestésica em cadelas submetidas à ovariosalpingohisterectomia eletiva / Evaluation of postoperative analgesia of dexmedetomidine alone or associated to morphine as premedicants in bitches undergoing ovariosalpingohisterectomy

Background: Elective ovariossalpingohysterectomy is a common surgery that causes mild to moderate pain. Aiming at the treatment of pain in these patients, analgesia should be balanced from pre-anesthetic, transoperative and postoperative medication, with-2-agonists and opioids being commonly used, especially dexmedetomidine that has sedation, relaxation muscle and analgesia.The aim of the present study was to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and associated withmorphine when used in the preanesthetic medication of bitches submitted to elective ovarian oysterectomy using the modifiedGlasgow pain scale and the Melbourne pain scale.Materials, Methods & Results: Twenty bitches were used in this study, all of them submitted to ovarian oysterectomy, and were clinically healthy according to laboratory and clinical exams. During the experiment, bitches were randomly distributed into two groups,which received preanesthetic medication (MPA) with 5 μg/kg dexmedetomidine alone (GD) or associated with 0.3 mg/kg morphine(GDM) intramuscularly (IM). In both groups, anesthetic induction with dose-effect propofol was performed and maintained withisoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the weightof the animal and maintained on spontaneous ventilation. After stabilization of the patient the surgery was started, which lasted 45min. The bitches were evaluated by the Modified Glasgow Scale (GSM), the Melbourne Scale (MS) and the Dobbins Sedation Scale(DS), previously administered MPA (T0) and the others performed in 1h (T1), 2h (T2), 4h (T3), 8h (T4), 12h (T5) and 24h (T6) afterextubation. If the GSM score was greater than the value of 3.3 an analgesic rescue of 0.5 mg/kg of morphine intramuscularly would beadministered. An increase in the scoring of pain scales in both groups can be observed from the T1, with significant difference only ofthe...(AU)

Cloridrato De Dexmedetomidina Como Medicação Pré-Anestésica Ou Sedativo Em Cães Relato De Dois Casos / Dexmedetomidine Hydrochloride As Premedication Or Sedative In Dogs - Report Of Two Cases / Cloridrato De Dexmedetomidina Como Medicación Preanestésica O Sedativa En Perros – Reporte De Dos Casos

Relata-se, dois casos, sendo que no primeiro, realizou-se cirurgia de OVH eletiva. Como MPA, utilizou-se 2,5 mcg/kg de cloridrato de dexmedetomidina e 0,2 mg/kg de cloridrato de metadona IM. A recuperação anestésica foi tranquila e sem complicações e o animal foi extubado após cinco minutos, recebendo alta do centro cirúrgico 30 minutos depois. No segundo caso, realizou-se cirurgia de sepultamento da glândula da terceira pálpebra. Como sedativo, utilizou-se 3,5 mcg/kg de cloridrato de dexmedetomidina e, como analgésico, 0,2 mg/kg de cloridrato de metadona IM. Ao término do procedimento cirúrgico, administrou-se 0,4 mcg/kg de cloridrato de atipamezole IM. Decorridos 15 minutos o paciente recuperou-se completamente, podendo ser encaminhado para alta cirúrgica. Os dois procedimentos transcorreram com valores de PAS  e bradicardia elevados,efeitos característicos do uso da dexmedetomidina. No primeiro caso a PAS se manteve entre 150 e 180 mmHg, no segundo, entre 160 e 180 mmHg. A partir dos casos relatados, conclui-se que o emprego da dexmedetomidina foi benéfico, proporcionando adequada medicação pré-anestésica e sedação nos referidos pacientes.

It is reported, two cases, being the first, elective OVH surgery was performed. As MPA, 2.5 mcg/kg dexmedetomidine hydrochloride and 0.2 mg/kg IM methadone hydrochloride were used. The anesthetic recovery was quiet and uncomplicated and the animal was extubated after five minutes, discharged from the operating room 30 minutes later. In the second case, the third eyelid gland was buried. As sedative, 3.5 mcg/kg of dexmedetomidine hydrochloride and as an analgesic, 0.2 mg/kg of methadone hydrochloride IM were used. At the end of the surgical procedure, 0.4 mcg/kg IM atipamezole hydrochloride was administered. After 15 minutes, the patient recovered completely and could be discharge from surgery. Both procedures showed high SBP values and bradycardia, characteristic effects of dexmedetomidine use. In the first case, SBP remained between 150 and 180 mmHg, in the second, between 160 and 180 mmHg. From the reported cases, it was concluded that the use of dexmedetomidine was beneficial, providing adequate pre-anesthetic medication and sedation in these patients.

Se presentan dos casos, y la primera se llevó a cabo la cirugía electiva OVH. Como MPA, se utiliza 2,5 mcg / kg de clorhidrato de dexmedetomidina y 0,2 mg kg IM / hidrocloruro de metadona. La recuperación de la anestesia fue tranquila y sin incidentes y el animal fue extubado después de cinco minutos, y fue dado de alta de la sala de operaciones 30 minutos más tarde. En el segundo caso, hubo cirugía del entierro de la glándula del tercer párpado. Como un sedante, se utiliza 3,5 mcg / kg de hidrocloruro de dexmedetomidina y, como un analgésico, 0,2 mg / kg IM clorhidrato de metadona. Al final de la intervención quirúrgica se administró 0,4 mcg / kg IM clorhidrato atipamezol. Después de 15 minutos, el paciente se recuperó completamente, y puede ser referido a alta quirúrgica. Los dos procedimientos pasados con valores altos y bradicardia PAS, los efectos característicos de la dexmedetomidina. En el primer caso, el PAS se mantuvo entre 150 y 180 mmHg en el segundo, entre 160 y 180 mmHg. De los casos reportados, se concluye que la dexmedetomidina fue beneficiosa, proporcionando una adecuada medicación preanestésica y sedación en estos pacientes.

Cloridrato De Dexmedetomidina Como Medicação Pré-Anestésica Ou Sedativo Em Cães Relato De Dois Casos / Dexmedetomidine Hydrochloride As Premedication Or Sedative In Dogs - Report Of Two Cases / Cloridrato De Dexmedetomidina Como Medicación Preanestésica O Sedativa En Perros Reporte De Dos Casos

Relata-se, dois casos, sendo que no primeiro, realizou-se cirurgia de OVH eletiva. Como MPA, utilizou-se 2,5 mcg/kg de cloridrato de dexmedetomidina e 0,2 mg/kg de cloridrato de metadona IM. A recuperação anestésica foi tranquila e sem complicações e o animal foi extubado após cinco minutos, recebendo alta do centro cirúrgico 30 minutos depois. No segundo caso, realizou-se cirurgia de sepultamento da glândula da terceira pálpebra. Como sedativo, utilizou-se 3,5 mcg/kg de cloridrato de dexmedetomidina e, como analgésico, 0,2 mg/kg de cloridrato de metadona IM. Ao término do procedimento cirúrgico, administrou-se 0,4 mcg/kg de cloridrato de atipamezole IM. Decorridos 15 minutos o paciente recuperou-se completamente, podendo ser encaminhado para alta cirúrgica. Os dois procedimentos transcorreram com valores de PAS  e bradicardia elevados,efeitos característicos do uso da dexmedetomidina. No primeiro caso a PAS se manteve entre 150 e 180 mmHg, no segundo, entre 160 e 180 mmHg. A partir dos casos relatados, conclui-se que o emprego da dexmedetomidina foi benéfico, proporcionando adequada medicação pré-anestésica e sedação nos referidos pacientes.(AU)

It is reported, two cases, being the first, elective OVH surgery was performed. As MPA, 2.5 mcg/kg dexmedetomidine hydrochloride and 0.2 mg/kg IM methadone hydrochloride were used. The anesthetic recovery was quiet and uncomplicated and the animal was extubated after five minutes, discharged from the operating room 30 minutes later. In the second case, the third eyelid gland was buried. As sedative, 3.5 mcg/kg of dexmedetomidine hydrochloride and as an analgesic, 0.2 mg/kg of methadone hydrochloride IM were used. At the end of the surgical procedure, 0.4 mcg/kg IM atipamezole hydrochloride was administered. After 15 minutes, the patient recovered completely and could be discharge from surgery. Both procedures showed high SBP values and bradycardia, characteristic effects of dexmedetomidine use. In the first case, SBP remained between 150 and 180 mmHg, in the second, between 160 and 180 mmHg. From the reported cases, it was concluded that the use of dexmedetomidine was beneficial, providing adequate pre-anesthetic medication and sedation in these patients.(AU)

Se presentan dos casos, y la primera se llevó a cabo la cirugía electiva OVH. Como MPA, se utiliza 2,5 mcg / kg de clorhidrato de dexmedetomidina y 0,2 mg kg IM / hidrocloruro de metadona. La recuperación de la anestesia fue tranquila y sin incidentes y el animal fue extubado después de cinco minutos, y fue dado de alta de la sala de operaciones 30 minutos más tarde. En el segundo caso, hubo cirugía del entierro de la glándula del tercer párpado. Como un sedante, se utiliza 3,5 mcg / kg de hidrocloruro de dexmedetomidina y, como un analgésico, 0,2 mg / kg IM clorhidrato de metadona. Al final de la intervención quirúrgica se administró 0,4 mcg / kg IM clorhidrato atipamezol. Después de 15 minutos, el paciente se recuperó completamente, y puede ser referido a alta quirúrgica. Los dos procedimientos pasados con valores altos y bradicardia PAS, los efectos característicos de la dexmedetomidina. En el primer caso, el PAS se mantuvo entre 150 y 180 mmHg en el segundo, entre 160 y 180 mmHg. De los casos reportados, se concluye que la dexmedetomidina fue beneficiosa, proporcionando una adecuada medicación preanestésica y sedación en estos pacientes.(AU)

Controle da dor crônica agudizada em cão submetido à exérese de mastocitoma / Control of acute chronic pain in a dog submitted to mastocytoma excision

Pain is characterized as an unpleasant sensory or emotional experience associated with actual or potential tissue damage resulting from a noxious stimulus that can lead to protein catabolism, stress, immunosuppression, delayed wound healing and acceleration of pathological processes. A dog with recurrent mastocytoma diagnosis was attended at the Veterinary Hospital of the State University of Ceará, and the lesions were widely located in the right thoracic dorsolateral region. The patient was submitted to the surgical procedure of tumor excision and the anesthetic protocol used had as main objective the control of the intraoperative and chronic oncologic pain that would be exacerbated by the surgery. The protocol used yielded good postoperative results and this reaffirms the importance of knowing the classification and pathophysiology of pain so that the veterinarian can take the most appropriate behavior, providing greater comfort and survival to the patient.

Controle da dor crônica agudizada em cão submetido à exérese de mastocitoma / Control of acute chronic pain in a dog submitted to mastocytoma excision

Pain is characterized as an unpleasant sensory or emotional experience associated with actual or potential tissue damage resulting from a noxious stimulus that can lead to protein catabolism, stress, immunosuppression, delayed wound healing and acceleration of pathological processes. A dog with recurrent mastocytoma diagnosis was attended at the Veterinary Hospital of the State University of Ceará, and the lesions were widely located in the right thoracic dorsolateral region. The patient was submitted to the surgical procedure of tumor excision and the anesthetic protocol used had as main objective the control of the intraoperative and chronic oncologic pain that would be exacerbated by the surgery. The protocol used yielded good postoperative results and this reaffirms the importance of knowing the classification and pathophysiology of pain so that the veterinarian can take the most appropriate behavior, providing greater comfort and survival to the patient.(AU)

Retrospective study of anesthesias in dogs and cats underwent to neurosurgery / Estudo retrospectivo das anestesias realizadas em cães e gatos submetidos à neurocirurgia

Background: The goal of anesthesia in patients with neurological diseases is to maintain the homeostasis of the central nervous system, focusing on intracranial pressure and pain during the intraoperative period. The purpose of this study was to evaluate the anesthesia performed between January 2010 and January 2016 at the Veterinary Clinical Hospital at the Federal University of Rio Grande do Sul and correlate the types of surgeries, drugs used in the pre-anesthetic medication, induction, pain control, and the development of complications during the procedure. Materials, Methods & Results: The medical records of 242 patients, who presented with neurological signs of spinal cord compression or traumatic brain injury, were assessed. Only 70 patients who underwent surgery had properly documented and detailed anesthesia records. Of these 70, there were 32 male and 38 female animals, with one feline and 69 canines. Their weights on the day of surgery ranged between 1.5 kg and 38 kg and their ages ranged from six months up to 13 years. We evaluated 74 surgeries because four patients underwent two separate surgeries. There were 38 hemilaminectomies, 14 ventral slots, seven vertebral stabilizations (one atlantoaxial instability and six vertebral fractures), six dorsal laminectomies, four pediculectomies, two fenestrations with hemilaminectomy, one durotomy with hemilaminectomy, on [...]

Retrospective study of anesthesias in dogs and cats underwent to neurosurgery / Estudo retrospectivo das anestesias realizadas em cães e gatos submetidos à neurocirurgia

Background: The goal of anesthesia in patients with neurological diseases is to maintain the homeostasis of the central nervous system, focusing on intracranial pressure and pain during the intraoperative period. The purpose of this study was to evaluate the anesthesia performed between January 2010 and January 2016 at the Veterinary Clinical Hospital at the Federal University of Rio Grande do Sul and correlate the types of surgeries, drugs used in the pre-anesthetic medication, induction, pain control, and the development of complications during the procedure. Materials, Methods & Results: The medical records of 242 patients, who presented with neurological signs of spinal cord compression or traumatic brain injury, were assessed. Only 70 patients who underwent surgery had properly documented and detailed anesthesia records. Of these 70, there were 32 male and 38 female animals, with one feline and 69 canines. Their weights on the day of surgery ranged between 1.5 kg and 38 kg and their ages ranged from six months up to 13 years. We evaluated 74 surgeries because four patients underwent two separate surgeries. There were 38 hemilaminectomies, 14 ventral slots, seven vertebral stabilizations (one atlantoaxial instability and six vertebral fractures), six dorsal laminectomies, four pediculectomies, two fenestrations with hemilaminectomy, one durotomy with hemilaminectomy, on [...](AU)

Effect of intravenous propofol and remifentanil on heart rate, blood pressure and nociceptive response in acepromazine premedicated dogs.

OBJECTIVE: To investigate the cardiorespiratory, nociceptive and endocrine effects of the combination of propofol and remifentanil, in dogs sedated with acepromazine. STUDY DESIGN: Prospective randomized, blinded, cross-over experimental trial. ANIMALS: Twelve healthy adult female cross-breed dogs, mean weight 18.4 ± 2.3 kg. METHODS: Dogs were sedated with intravenous (IV) acepromazine (0.05 mg kg(-1) ) followed by induction of anesthesia with IV propofol (5 mg kg(-1) ). Anesthesia was maintained with IV propofol (0.2 mg kg(-1) minute(-1) ) and remifentanil, infused as follows: R1, 0.125 µg kg(-1) minute(-1) ; R2, 0.25 µg kg(-1) minute(-1) ; and R3, 0.5 µg kg(-1) minute(-1) . The same dogs were administered each dose of remifentanil at 1-week intervals. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (f(R) ), end tidal CO(2) (Pe'CO(2) ), arterial hemoglobin O(2) saturation, blood gases, and rectal temperature were measured before induction, and 5, 15, 30, 45, 60, 75, 90, and 120 minutes after beginning the infusion. Nociceptive response was investigated by electrical stimulus (50 V, 5 Hz and 10 ms). Blood samples were collected for plasma cortisol measurements. Statistical analysis was performed by anova (p<0.05). RESULTS: In all treatments, HR decreased during anesthesia with increasing doses of remifentanil, and increased significantly immediately after the end of infusion. MAP remained stable during anesthesia (72-98 mmHg). Antinociception was proportional to the remifentanil infusion dose, and was considered satisfactory only with R2 and R3. Plasma cortisol concentration decreased during anesthesia in all treatments. Recovery was smooth and fast in all dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Infusion of 0.25-0.5 µg kg(-1) minute(-1) remifentanil combined with 0.2 mg kg(-1) minute(-1) propofol produced little effect on arterial blood pressure and led to a good recovery. The analgesia produced was sufficient to control the nociceptive response applied by electrical stimulation, suggesting that it may be appropriate for performing surgery.

Comparison of xylazine and medetomidine as premedicants for cats being anaesthetised with propofol-sevoflurane.

The effects of premedicating cats with saline, xylazine or medetomidine before anaesthetising them with propofol-sevoflurane were compared. Twenty-four cats were randomly assigned to three groups of eight to receive either 0.25 ml of saline, 0.50 mg/kg of xylazine or 0.02 mg/kg of medetomidine intravenously, and anaesthesia was induced with propofol and maintained with sevoflurane. Medetomidine produced a greater reduction in the induction dose of propofol and fewer adverse postoperative effects than saline or xylazine. Hypoxaemia was observed after induction with propofol in the cats premedicated with saline and xylazine, but not in the cats given medetomidine. The cats treated with medetomidine and xylazine developed profound bradycardia. The blood pressure of the cats premedicated with saline and xylazine decreased, but the blood pressure of the cats premedicated with medetomidine was maintained. The cats premedicated with saline took longer to recover from anaesthesia than the other two groups.

Effects of two preanesthetic regimens for ophthalmic surgery on intraocular pressure and cardiovascular measurements in dogs.

The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure were investigated in 20 dogs. Following administration of preanesthetics and induction of anesthesia, dogs were intubated and anesthesia was maintained with halothane for 10 minutes. Intraocular pressure was significantly higher (P <.05) at several evaluations for dogs premedicated with acepromazine/meperidine than for those premedicated with acepromazine/butorphanol. Mean heart rate and diastolic arterial blood pressure were significantly (P <.05) higher 5 minutes after administration of acepromazine/meperidine than after acepromazine/butorphanol. Results of this study suggest that acepromazine/butorphanol is a satisfactory preanesthetic combination to use before induction of anesthesia with midazolam and ketamine for ophthalmic surgery in dogs.

Anestesia em cães utilizando éter glicerol guaiacol, quetamina e fentanil em infusão contínua intravenosa / Anaesthesia in dogs using continuous intravenous infusion of guaiphenesin, ketamine and fentanyl

Onze cães, sem raça definida, receberam como medicação pré-anestésica a anestesia induzida e mantida por infusão contínua intravenosa de quetamina e fentanil em solução de éter gliceril guaiacol a 5% em glicose a 5%, através de bomba de infusão. Em seis animais foram mensuradas frequência cardíaca e respiratória, ventilometria (volume corrente e volume minuto), pressão arterial (sistólica, média e diastólica), temperatura retal, hemogasometria arterial, saturação de 02 na hemogoblina, anion residual, osmolalidade sérica, concentração sérica total de 02, hematócrito, hemoglobina, glicose e eletrólitos. Avaliou-se também a analgesia através de pinçamento da pele da região glabra. Em outro grupo de cinco animais, onde foram realizadas três ovários-salpingo-histerectomias e duas osteossínteses, foram mensuradas a frequência cardíaca e respiratória e a resposta ao estímulo cirúrgico. Em ambos os grupos observou-se, principalmente, depressão respiratória dose-dependente, agravada com o uso de velocidade de infusão elevada, no caso de manobras cirúrgicas muito cruentas, como manipulação de periósteo.

Eleven mongrel dogs were premedicated with methotrimeprazine. Anaesthesia was induced and main-tained by continuous intravenous infusion of a 5% glucose solution containing guaiphenesin, ketamine and fentanyl. Heart and respiratory rates, tidal and minute volume, systolic, mean and diastolic blood pressure, temperature, arterial blood gases, hemoglobin oxygen saturation, anion gap, serum osmolality, serum oxygen concentration, packed cell volume, hemoglobin, glucose and electrolytes were measured in six dogs. Analgesia was investigated usind a forceps in the skin. In the other five dogs heart and respiratory rates and response to surgical stimulus were investigated. Respiratory acidosis, hypoximia and hypoventilation were observed. Respiratory depression was proportional to the infusion rate, particulary when high infusion rates were used for bone repair.

Efeitos sedativos das associações xilazina/midazolam e medetomidina/midazolan no gato (Felis catus) / Sedative effects of xylazine/midazolam and medetomidine/midazolam in cats

Vinte gatos, machos, sem raça definida, com 1 a 2 anos de idade, hígidos, foram divididos em dois grupos iguais. Em ambos os grupos utilizou-se como medicação pré-anestésica o sulfato de atropina, na dose de 0,03 mg/k, por via intramuscular, 20 minutos antes da administração da associação dos alfa-2 agonistas e do midazolam. O primeiro grupo (x/m) foi submetido à administração intramuscular da associação xilazinal midazolam, nas doses de 1 mg/kg e 0,2 mg/kg e o segundo grupo (m/m) à associação medetomidinal midazolam, nas doses de 0,08 mg/kg, e 0,2 mg/kg, respectivamente. A administração simultânea de alfa-2 agonistas e midazolam induziu a uma rápida e profunda depressão do SNC, que foi mais rápida com a combinação medetomidina/midazolam. O efeito sedativo máximo ocorreu entre 20-30 min. com ambas as combinações. A recuperação foi tranquila sem alterações expressivas.

Twenty healthy tom cats, from 1 to 2 years of age and weighting between 3,5 and 5 kg were used in the study. The animais were divided into two groups and were premedicated with 0,03mg/kg of atropine sulfate i.m. 20 min prior to the administration of 1 mg/kg xykazine and 0,2 mg/kg midazolam (group m/m - n = 1 O) i.m .. The combination of alfa2 agonists and midazolam induced a rapid CNS depression. The onset of sedation was earlier with m/m than x/m. The maximal sedative effect occurred at 20 to 30 min with the two combinations and recovery was uneventful.