RESUMO

Dipyrone is an effective analgesic for managing moderate or severe postoperative pain and can be used alone for mild pain or in combination with other analgesics for any type of pain. This study aimed to examine the administration of dipyrone by continuous infusion (CI) as an adjuvant analgesic in the intraoperative period for bitches undergoing elective ovariohysterectomy (OH) and its effect on these patients' cardiorespiratory parameters. Twenty bitches underwent an elective OH procedure. The pre-anesthetic agent was a combination of acepromazine and morphine. Propofol was used to induce anesthesia, and isoflurane was used for maintenance. Subsequently, the animals were randomly allocated into two groups: the dipyrone group (DG) received a bolus dose of dipyrone (25 mg kg-1) by CI at a rate of 10 mg kg-1 h, and the control group (CG) received a bolus dose and a CI of 0.9% NaCl solution, both groups at a rate of 5 mL kg-1 h. The parametric variables were analyzed by ANOVA, followed by Tukey's test (p <0.05). The paired t-test (p <0.05) was used for comparison between the groups. Statistical differences were observed for heart rate, systolic, diastolic, and mean arterial pressure, respiratory rate, and blood glucose between the periods in both groups. There were differences only in the basal values of MAP between the groups; however, most values remained within the physiological range for the species. Using the drug as an adjuvant to anesthesia did not alter cardiorespiratory parameters, and it can be used as an adjuvant in analgesia during the intraoperative period of OH.(AU)

A dipirona é um analgésico eficaz para o manejo da dor pós-operatória moderada ou grave, podendo ser utilizada isoladamente em dores leves ou associada a outros analgésicos em qualquer tipo de dor. O presente estudo teve como objetivo avaliar a utilização de infusão contínua (IC) de dipirona no período transoperatório de cadelas submetidas à Ovariohisterectomia (OH) eletiva como adjuvante analgésico, avaliando seu efeito sobre parâmetros cardiorrespiratórios desses pacientes. Para o estudo, 20 cadelas foram submetidas ao procedimento de OH eletiva. A medicação pré-anestésica foi composta pela associação de acepromazina e morfina, seguida da indução com propofol e manutenção com isofluorano. Posteriormente, os animais foram alocados, aleatoriamente, em dois grupos: dipirona (GD), que receberam bolus de dipirona (25 mg kg-1) seguido da IC do fármaco na taxa de 10 mg kg-1 h, e grupo controle (GC), cujos animais receberam o bolus e IC de solução de NaCl 0,9%, ambos os grupos na velocidade de 5 mL kg-1 h. Variáveis paramétricas foram analisadas pela ANOVA seguida pelo teste de Tukey (p <0,05) e comparadas entre os grupos pelo teste t pareado (p <0,05). Foram observadas diferenças estatísticas entre os momentos em ambos os grupos em relação à FC, FR, PAS, PAM, PAD e glicemia. Entre os grupos, houve apenas diferenças nos valores basais de PAM, no entanto, a maioria dos valores manteve-se dentro da faixa considerada fisiológica para a espécie. A utilização do fármaco como adjuvante a anestesia não alterou os parâmetros cardiorrespiratórios, podendo ser utilizado como adjuvante na analgesia durante o transoperatório de OH.(AU)

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RESUMO

Background: Tracheal intubation is performed in an anesthetized patient in order to optimize oxygenation and to allow the administration of volatile anesthetics. Some patients have characteristics that make intubation a challenge. Therefore, an adequate pre-anesthetic evaluation enables the anesthesiologist to define the best management. There are reports of the impossibility of performing conventional intubation attributed to the lack of pre-anesthetic consultation in Medicine, which motivates and justifies the discussion of these aspects in Veterinary Medicine. Therefore, this study aims to report a case of difficult airway management in a feline with tonsillitis. Case: A 3-year-old male NDB cat weighing 3.5 kg was admitted to the Veterinary Hospital, Federal University of Pampa (UNIPAMPA) - Uruguaiana, for consultation. After physical examination, total tooth extraction and tonsillectomy was recommended. On the day of the procedure, a physical evaluation of the patient was performed, and he was classified as ASA II. Zolazepam and tiletamine [Zoletil® - 5 mg/kg, i.m] associated with morphine [Dimorf® - 0.3 mg/kg, i.m] was given as premedication. Given the difficulty of intubation in a previous procedure reported by the tutor, a thoughtful conduct was planned for the intubation of the patient, considering the possibility of tracheostomy. The patient was pre-oxygenated, and subsequently, propofol [Propovan® - 4 mg/kg, i.v] was administered to promote anesthetic induction. The first attempt at intubation was done by laryngoscopy, but despite the use of a 6 cm blade, it was too large in relation to the hyperplastic tissue; then swabs and a flashlight were subsequently used. With the help of 2 people, the experienced anesthesiologist was able to position the endotracheal tube correctly approximately 25 min after the first attempt, requiring supplemental doses of propofol [Propovan® to the effect, i.v] and oxygenation between the attempts. Anesthetic maintenance was achieved with isoflurane [Isoforine® vaporized in 100% oxygen] in a system without gas rebreathing. Locoregional block of the maxillary nerve and inferior branch of the mandibular nerve was performed with lidocaine 2% [0.1 mL/kg]. During the transoperative, the vital parameters remained stable and there was no need for analgesic rescue. After the end of the procedure and extubation, the patient received oxygen therapy via facemask until he regained consciousness and had no complications. Discussion: The mortality of dogs and cats related to anesthetic procedures is substantially higher when compared to humans. Studies have shown that most anesthetic-related complications in humans are predictable. The lack of adequate pre-anesthetic evaluation or anesthetic consultation are factors that can cause losses in the transoperative period. Therefore, sharing information that can mitigate these situations is critical. The scarcity of reports on pre-anesthetic evaluation in veterinary medicine allows the identification of a gap on the role of the anesthesiologist in this important stage of anesthesia, and how it is performed in the hospital routine or in veterinary clinics. The success in managing the difficult airway in the case reported here can be attributed to the procedures adopted in all stages of the procedure, especially the planning based on information obtained during the pre-anesthetic period. It is worth mentioning that the owner was a veterinarian and we believe this also contributed to the outcome, since he informed the anesthesiologist about the difficulties encountered during the previous procedure. This case motivated the implementation of a pre-anesthetic consultation service in the hospital in question. In addition to the physical examination, a complete anamnesis carried out with the owner may reveal relevant details for determining the most appropriate and safe anesthetic conduct for the patient.

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