RESUMO
Background: Cardiopulmonary arrest (CPA) is common in veterinary critical care and cardiopulmonary cerebral resuscitation (CPCR) aims to achieve survival and continued quality of life. However, reported survival rate to discharge is very low for veterinary patients. We present a case of successful CPCR after CPA in a bitch undergoing cesarean section and ovariohysterectomy.Case: A four-year old Pit Bull bitch undergoing labor for two days was referred to the veterinary hospital for a cesarean section and ovariohysterectomy. Laboratory exams revealed anemia, leucopenia, hypoglycemia and increased values of alkaline phosphatase and urea. Pre-anesthetic medication consisted of intramuscular (IM) morphine (0.3 mg kg-1) and midazolam (0.2 mg kg-1), and 2.5% glucose in Ringers lactated solution (10 mL kg-1 hour-1) was administered intravenously (IV). Following induction with propofol (2 mg kg-1) and midazolam (0.2mg kg-1) IV, the trachea was intubated and anesthesia was maintained with isofl urane in 100% oxygen. Fentanyl (3g kg-1) associated with 2% lidocaine (4 mg kg-1) was administered epidurally in the lumbo-sacral space. During anesthesia, heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), electrocardiogram (ECG) and systolic arterial pressure (SAP) were monitored. At the start of surgery, blood was transfused. During the procedure, hypotension (SAP 3
Background: Cardiopulmonary arrest (CPA) is common in veterinary critical care and cardiopulmonary cerebral resuscitation (CPCR) aims to achieve survival and continued quality of life. However, reported survival rate to discharge is very low for veterinary patients. We present a case of successful CPCR after CPA in a bitch undergoing cesarean section and ovariohysterectomy.Case: A four-year old Pit Bull bitch undergoing labor for two days was referred to the veterinary hospital for a cesarean section and ovariohysterectomy. Laboratory exams revealed anemia, leucopenia, hypoglycemia and increased values of alkaline phosphatase and urea. Pre-anesthetic medication consisted of intramuscular (IM) morphine (0.3 mg kg-1) and midazolam (0.2 mg kg-1), and 2.5% glucose in Ringers lactated solution (10 mL kg-1 hour-1) was administered intravenously (IV). Following induction with propofol (2 mg kg-1) and midazolam (0.2mg kg-1) IV, the trachea was intubated and anesthesia was maintained with isofl urane in 100% oxygen. Fentanyl (3g kg-1) associated with 2% lidocaine (4 mg kg-1) was administered epidurally in the lumbo-sacral space. During anesthesia, heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), electrocardiogram (ECG) and systolic arterial pressure (SAP) were monitored. At the start of surgery, blood was transfused. During the procedure, hypotension (SAP 3
RESUMO
Background: Cardiopulmonary arrest (CPA) is common in veterinary critical care and cardiopulmonary cerebral resuscitation (CPCR) aims to achieve survival and continued quality of life. However, reported survival rate to discharge is very low for veterinary patients. We present a case of successful CPCR after CPA in a bitch undergoing cesarean section and ovariohysterectomy.Case: A four-year old Pit Bull bitch undergoing labor for two days was referred to the veterinary hospital for a cesarean section and ovariohysterectomy. Laboratory exams revealed anemia, leucopenia, hypoglycemia and increased values of alkaline phosphatase and urea. Pre-anesthetic medication consisted of intramuscular (IM) morphine (0.3 mg kg-1) and midazolam (0.2 mg kg-1), and 2.5% glucose in Ringers lactated solution (10 mL kg-1 hour-1) was administered intravenously (IV). Following induction with propofol (2 mg kg-1) and midazolam (0.2mg kg-1) IV, the trachea was intubated and anesthesia was maintained with isofl urane in 100% oxygen. Fentanyl (3g kg-1) associated with 2% lidocaine (4 mg kg-1) was administered epidurally in the lumbo-sacral space. During anesthesia, heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), electrocardiogram (ECG) and systolic arterial pressure (SAP) were monitored. At the start of surgery, blood was transfused. During the procedure, hypotension (SAP 3
Background: Cardiopulmonary arrest (CPA) is common in veterinary critical care and cardiopulmonary cerebral resuscitation (CPCR) aims to achieve survival and continued quality of life. However, reported survival rate to discharge is very low for veterinary patients. We present a case of successful CPCR after CPA in a bitch undergoing cesarean section and ovariohysterectomy.Case: A four-year old Pit Bull bitch undergoing labor for two days was referred to the veterinary hospital for a cesarean section and ovariohysterectomy. Laboratory exams revealed anemia, leucopenia, hypoglycemia and increased values of alkaline phosphatase and urea. Pre-anesthetic medication consisted of intramuscular (IM) morphine (0.3 mg kg-1) and midazolam (0.2 mg kg-1), and 2.5% glucose in Ringers lactated solution (10 mL kg-1 hour-1) was administered intravenously (IV). Following induction with propofol (2 mg kg-1) and midazolam (0.2mg kg-1) IV, the trachea was intubated and anesthesia was maintained with isofl urane in 100% oxygen. Fentanyl (3g kg-1) associated with 2% lidocaine (4 mg kg-1) was administered epidurally in the lumbo-sacral space. During anesthesia, heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), electrocardiogram (ECG) and systolic arterial pressure (SAP) were monitored. At the start of surgery, blood was transfused. During the procedure, hypotension (SAP 3
RESUMO
Ketamine has demonstrated analgesic effects in subanesthetic doses, besides the maintenance of stability of physiological parameters. The study aimed to evaluate the cardiorespiratory effects and the post operative analgesia of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route), CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine), CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV) and CON (epidural anesthesia with lidocaine 2%). HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.
A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural), CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma), CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1) e CON (anestesia epidural com lidocaína 2%). Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur.
RESUMO
Ketamine has demonstrated analgesic effects in subanesthetic doses, besides the maintenance of stability of physiological parameters. The study aimed to evaluate the cardiorespiratory effects and the post operative analgesia of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route), CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine), CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV) and CON (epidural anesthesia with lidocaine 2%). HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.
A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural), CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma), CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1) e CON (anestesia epidural com lidocaína 2%). Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur.
RESUMO
Ketamine has demonstrated analgesic effects in subanesthetic doses, besides the maintenance of stability of physiological parameters. The study aimed to evaluate the cardiorespiratory effects and the post operative analgesia of ketamine via epidural route, intravenous continuous infusion or association of both, in dogs submitted to femoral osteosynthesis. Twenty-five healthy bitches were randomly assigned to four groups: CEP (2mg kg-1 of ketamine associated with lidocaine 2% via epidural route), CIV (lidocaine 2% via epidural route and 1mg kg-1 of ketamine IV, followed by IV continuous infusion of 100µg kg min-1 of ketamine), CIVEP (epidural anesthesia identical to CEP and ketamine infusion as in CIV) and CON (epidural anesthesia with lidocaine 2%). HR, RR, SAP, MAP, DAP and T°C, sensitive blockade time and post operative analgesia measured with visual analog scale were evaluated. There was an increase in HR in CIV and decrease of this parameter in CEP. Arterial pressures kept within physiological values and differences in RR and T°C were not observed. The anesthetic blockade time was augmented in the groups which received epidural ketamine, differing significantly in relation to the control. The time for rescue analgesia did not differ between the groups. It can be concluded the administration of ketamine via epidural route, intravenous continuous infusion or the association of both promoted cardiorespiratory stability during the operative period; however, it was not able to extend the duration of post operative analgesia in dogs submitted to femoral osteosynthesis.
A cetamina tem demonstrado efeito analgésico em doses subanestésicas, além da manutenção da estabilidade dos parâmetros fisiológicos. O estudo objetivou avaliar os efeitos cardiorrespiratórios e a analgesia pós-operatória da cetamina administrada por via epidural, por infusão intravenosa contínua ou pela associação de ambas, em cães submetidos à osteossíntese de fêmur. Foram utilizadas 25 cadelas, hígidas, distribuídas aleatoriamente em quatro grupos: CEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural), CIV (lidocaína 2% via epidural e 1mg kg-1 de cetamina IV seguido de infusão contínua IV com 100µg kg min-1 da mesma), CIVEP (2mg kg-1 de cetamina associada à lidocaína 2% via epidural e 1mg kg-1 de cetamina IV, seguido de infusão contínua IV com 100µg kg min-1) e CON (anestesia epidural com lidocaína 2%). Avaliaram-se FC, f, PAS, PAM, PAD, T°C, tempo de bloqueio motor e analgesia pós-operatória por meio de escala analógica visual. Houve elevação da FC no CIV e diminuição desse parâmetro no CEP. As pressões arteriais mantiveram-se dentro dos valores fisiológicos e não foram observadas diferenças na f e T°C. O tempo de duração do bloqueio anestésico foi potencializado nos grupos que receberam cetamina epidural, diferindo significativamente em relação ao controle. O tempo para a analgesia resgate não diferiu entre os grupos. Conclui-se que a administração de cetamina pela via epidural, por infusão contínua intravenosa ou pela associação de ambas promoveu estabilidade cardiorrespiratória no período transcirúrgico, porém não foi capaz de prolongar a duração da analgesia pós-operatória em cães submetidos à osteossíntese de fêmur.