Comparação dos efeitos cardiorrespiratórios e eficácia analgésica perioperatória da infusão contínua de dexmedetomidina ou fentanil durante a ovariohisterectomia de cadelas anestesiadas com propofol

Autores

DOI:

https://doi.org/10.33448/rsd-v12i13.43594

Palavras-chave:

Anestesia total intravenosa; Cachorro; Dexmedetomidina; Fentanil; Propofol.

Resumo

O estudo objetivou comparar os efeitos cardiorrespiratórios, analgésicos perioperativos e hemogasométricos de 16 cadelas submetidas a ovariohisterectomia eletiva sob infusão contínua de dexmedetomidina ou fentanil. Os cães foram pré-medicados com morfina (0,5 mg/kg) e dexmedemidina (5 µg/kg) ou acepromazina (0,05 mg/kg), ambos intramuscular (IM), no GDEX ou GFEN, respectivamente. Depois na indução anestésica com propofol intravenoso (IV), os animais do GFEN receberam bolus de fentanil (2,5 µg/kg) IV seguido de infusão contínua (IC) (10 µg/kg/h) e o GDEX recebeu bolus de solução salina 0,9% (volume correspondente de fentanil) seguido de IC de dexmedetomidina (1 µg/kg/h) e a anestesia foi mantida com propofol (0,22 mg/kg/min). Ao final do procedimento todos os animais foram avaliados usando a Escala composta de dor de Glasgow (GCPS) e a Escala analógica visual (VAS). Os dados foram comparados com um valor estatística de p > 0,05. A média da frequência cardíaca foi estatisticamente menor no GDEX quando comparado ao GFEN (p = 0,0498): 54,25 ± 3,919 e 88,38 ± 8,766 batimentos por minuto, respectivamente. Em oposição, a média final da pressão arterial média foi estatisticamente maior no GDEX quando comparado ao GFEN (p = 0,0021): 99,38 ± 8,551 e 80,75 ± 11,12 mmHg, respectivamente. O GDEX e GFEN, nas primeiras 4 e 2 horas de pós-operatório, respectivamente, apresentaram escores estatisticamente maiores que o basal pela GCPS, ocorrendo resgate analgésico em ambos os grupos. Conclui-se que ambos os fármacos nas taxas propostas foram seguros e eficientes no controle nociceptivo intraoperatório, no entanto, falharam em promover analgesia pós-operatória.

Referências

Andreoni, V., & Lynne Hughes, J. (2009). Propofol and fentanyl infusions in dogs of various breeds undergoing surgery. Veterinary Anaesthesia and Analgesia, 36(6), 523–531.

Brodeur, A., Wright, A., & Cortes, Y. (2017). Hypothermia and targeted temperature management in cats and dogs. Journal of Veterinary Emergency and Critical Care, 27(2), 151–163.

Bustamante, R., Aguado, D., Cediel, R, Gómez de Segura, I. A., & Canfrán, S (2018). Clinical comparison of the effects of isoflurane or propofol anaesthesia on mean arterial blood pressure and ventilation in dogs undergoing orthopaedic surgery receiving epidural anaesthesia. The Veterinary Journal, 233, 49–54.

Canfrán, S., Bustamante, R., González, P., Cediel, R., Re, M., & de Segura, I. A. G. (2016). Comparison of sedation scores and propofol induction doses in dogs after intramuscular administration of dexmedetomidine alone or in combination with methadone, midazolam, or methadone plus midazolam. The Veterinary Journal, 210, 56–60.

Clark-Price, S. (2015). Inadvertent Perianesthetic Hypothermia in Small Animal Patients. Veterinary Clinics of North America: Small Animal Practice, 45(5), 983–994.

Davis, C. A., Seddighi, R., Cox, S. K., Sun, X., Egger, C. M., & Doherty, T. J. (2017). Effect of fentanyl on the induction dose and minimum infusion rate of propofol preventing movement in dogs. Veterinary Anaesthesia and Analgesia, 44(4), 727–737.

Dutta, S., Karol, M. D., Cohen, T., Jones, R. M., & Mant, T. (2001). Effect of dexmedetomidine on propofol requirements in healthy subjects. Journal of Pharmaceutical Sciences, 90(2), 172–181.

Dyson, D. H. (2008). Perioperative Pain Management in Veterinary Patients. Veterinary Clinics of North America: Small Animal Practice, 38(6), 1309–1327.

Gaynor JS, Muir III WW (2015). Acute Pain Management. Veterinary Pain Management (3rd edn). Gaynor JS, Muir III WW (eds.). Saunders Elsevier, USA, 444–471.

Grasso, S. C., Ko, J. C., Weil, A. B., Paranjape, V., & Constable, P. D. (2015). Hemodynamic influence of acepromazine or dexmedetomidine premedication in isoflurane-anesthetized dogs. Journal of the American Veterinary Medical Association, 246(7), 754–764.

Grubb, T., Sager, J., Gaynor, J. S., Montgomery, E., Parker, J. A., Shafford, H., & Tearney, C. (2020). 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association, 56(2), 59–82.

Gutierrez-Blanco, E., Victoria-Mora, J. M., Ibancovichi-Camarillo, J. A., Sauri-Arceo, C. H., Bolio-González, M. E., Acevedo-Arcique, C. M., Marin-Cano, G., & Steagall, P. V. (2015). Postoperative analgesic effects of either a constant rate infusion of fentanyl, lidocaine, ketamine, dexmedetomidine, or the combination lidocaine-ketamine-dexmedetomidine after ovariohysterectomy in dogs. Veterinary Anaesthesia Analgesia, 42(3):309-18.

Hansen, B. D. (2005). Analgesia and sedation in the critically ill. Journal of Veterinary Emergency and Critical Care, 15(4), 285–294.

Hernández-Avalos, I., Valverde, A., Ibancovichi-Camarillo, J. A., Sánchez-Aparicio, P., Recillas-Morales, S., Osorio-Avalos, J., Rodríguez-Velázquez, D., & Miranda-Cortés, A. E. (2020). Clinical evaluation of postoperative analgesia, cardiorespiratory parameters and changes in liver and renal function tests of paracetamol compared to meloxicam and carprofen in dogs undergoing ovariohysterectomy. PLOS ONE, 15(2), e0223697.

Hwang, W., Lee, J., Park, J., & Joo, J. (2015). Dexmedetomidine versus remifentanil in postoperative pain control after spinal surgery: a randomized controlled study. BMC Anesthesiology, 15(1), 15–21.

Khan, Z. H., Arab, S., & Emami, B. (2011). Comparison of the effects of anesthesia with isoflurane and total intravenous anesthesia on the intensity of body temperature reduction during anesthesia and incidence of postoperative chills. Acta Med Iran, 49(7), 425-432.

Liu, W-S., Bidwai, A. V., Stanley, T. H., & Isern-Amaral, J. (1976). Cardiovascular Dynamics After Large Doses of Fentanyl and Fentanyl Plus N2O in the Dog. Anesthesia & Analgesia, 55(2), 168–172.

Martin-Flores, M., Mostowy, M. M., Pittman, E., Sakai, D. M., Mohammed, H. O., Gleed, R. D., & Campoy, L. (2019). Investigation of associations between preoperative acepromazine or dexmedetomidine administration and development of arterial hypotension or bradycardia in dogs undergoing ovariohysterectomy. Journal of the American Veterinary Medical Association, 255(2), 193–199.

McEwan, A. I., Smith, C., Dyar, O., Goodman, D., Smith, L. R., & Glass, O. S. (1993). Isoflurane minimum alveolar concentration reduction by fentanyl. Anesthesiology, 78(5), 864–869.

Mendes, G. M., & Selmi, A. L. (2003). Use of a combination of propofol and fentanyl, alfentanil, or sufentanil for total intravenous anesthesia in cats. Journal of the American Veterinary Medical Association, 223(11), 1608–1613.

Moura, R. S., Bittar, I. P., Gomes, J. H., de Oliveira, Y. V. R., de Sousa Filho, G. D., de Faria Soares, G. C. F., Lima, E. M., & Franco, L. G. (2022). Plasma concentration, cardiorespiratory and analgesic effects of ketamine-fentanyl infusion in dogs submitted to mastectomy. BMC Vet Res. 18(1):225.

Murrell J C & Hellebrekers L J (2005). Medetomidine and dexmedetomidine: a review of cardiovascular effects and antinociceptive properties in the dog. Veterinary Anaesthesia and Analgesia, 32(3), 117–127.

Naaz, S. (2014). Dexmedetomidine in Current Anaesthesia Practice- A Review. Journal Of Clinical and Diagnostic Research, 8(10), GE01–GE04.

Nagashima, J. K., Gonçalves, L. A., Pereira, M. A., Talib, M. S., de Olveira, C. M., Ambrósio, A. M., & Fantoni, D. T. (2022). Microcirculation assessment of dexmedetomidine constant rate infusion during anesthesia of dogs with sepsis from pyometra: a randomized clinical study. Veterinary Anaesthesia and Analgesia. 49(6):536-545. 10.1016/j.vaa.2022.07.005.

Pascoe, P. J. (2000). Opioid Analgesics. Veterinary Clinics of North America: Small Animal Practice, 30(4), 757–772.

Pascoe, P. J., Raekallio, M., Kuusela, E., McKusick, B., & Granholm, M. (2006). Changes in the minimum alveolar concentration of isoflurane and some cardiopulmonary measurements during three continuous infusion rates of dexmedetomidine in dogs. Veterinary Anaesthesia and Analgesia, 33(2), 97–103.

Raffe, M. R. (2020). Total Intravenous Anesthesia for the Small Animal Critical Patient. Vet Clin North Am Small Anim Practice, 50(6), 1433-1444.

Robinson, T. M., Kruse-Elliott, K. T., Markel, M. D., Pluhar, G. E., Massa, K., & Bjorling, D. E. (1999). A comparison of transdermal fentanyl versus epidural morphine for analgesia in dogs undergoing major orthopedic surgery. J Am Anim Hosp Assoc, 35(2), 95–100.

Sano, T., Nishimura, R., Kanazawa, H., Igarashi, E., Nagata, Y., Mochizuki, M., & Sasaki, N. (2006). Pharmacokinetics of fentanyl after single intravenous injection and constant rate infusion in dogs. Veterinary Anaesthesia and Analgesia, 33(4), 266–273.

Simon, B. T., Scallan, E. M., Coursey, C. D., Kiehl, W. M., & Moore, E. J. (2018). The clinical effects of a low dose dexmedetomidine constant rate infusion in isoflurane anesthetized cats. The Veterinary Journal, 234, 55–60.

Smith, C. K., Seddighi, R., Cox, S. K., Sun, X., Knych, H. K., & Doherty, T. J. (2017). Effect of dexmedetomidine on the minimum infusion rate of propofol preventing movement in dogs. Veterinary Anaesthesia and Analgesia, 44(6), 1287–1295.

Uilenreef, J. J., Murrell, J. C., McKusick, B. C., & Hellebrekers, L. J. (2008). Dexmedetomidine continuous rate infusion during isoflurane anaesthesia in canine surgical patients. Veterinary Anaesthesia and Analgesia, 35(1), 1–12.

Valtolina, C., Robben, J. H., Uilenreef, J., Murrell, J. C., Aspegrén, J., McKusick, B. C., & Hellebrekers, L. J. (2009). Clinical evaluation of the efficacy and safety of a constant rate infusion of dexmedetomidine for postoperative pain management in dogs. Veterinary Anaesthesia and Analgesia, 36(4), 369–383.

Van Oostrom, H., et al. (2011). Neurophysiological assessment of the sedative and analgesic effects of a constant rate infusion of dexmedetomidine in the dog. The Veterinary Journal, 190(3), 338–344.

Varvel, J. R., Shafer, S. L., Hwang, S. S., Coen, P. A., & Stanski, D. R. (1989). Absorption characteristics of transdermally administered fentanyl. Anesthesiology, 70(6), 928–934.

Wagner, A. E., & Hellyer, P. W. (2002). Observations of Private Veterinary Practices in Colorado, with an Emphasis on Anesthesia. Journal of Veterinary Medical Education, 29(3), 176–182.

Williamson, A. J., Soares, J. H. N., Pavlisko, N. D., McAlister Council-Troche, R., & Henao-Guerrero, N. (2017). Isoflurane minimum alveolar concentration sparing effects of fentanyl in the dog. Veterinary Anaesthesia and Analgesia, 44(4), 738–745.

Yaksh, T. L., Noueihed, R. Y., & Durant, P. A. (1986). Studies of the pharmacology and pathology of intrathecally administered 4-anilinopiperidine analogues and morphine in the rat and cat. Anesthesiology, 64(1), 54–66.

Yazdi, B., Modir, H., Kamali, A., & Masouri, H. (2020). Change in saturation oxygen and hemodynamic responses by adding intrathecal dexmedetomidine vs. sufentanil to bupivacaine in patients undergoing dynamic hip screw operation: a randomized clinical trial. Med Gas Res, 10(4), 144–148.

Downloads

Publicado

25/11/2023

Como Citar

CONTERNO, G.; COMASSETTO, F.; CONSOLIM, M. G. .; TOCHETO, R.; OLESKOVICZ, N. Comparação dos efeitos cardiorrespiratórios e eficácia analgésica perioperatória da infusão contínua de dexmedetomidina ou fentanil durante a ovariohisterectomia de cadelas anestesiadas com propofol. Research, Society and Development, [S. l.], v. 12, n. 13, p. e17121343594, 2023. DOI: 10.33448/rsd-v12i13.43594. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/43594. Acesso em: 22 nov. 2024.

Edição

Seção

Ciências da Saúde