Estudo comparativo entre anestesia venosa total alvo-controlada e por infusão contínua em cães pré-tratados com levomepromazina e tratados com propofol e remifentanila
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Data
2007-08-24
Autores
Hatschbach, Eduardo [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A anestesia venosa total possui muitas vantagens, não polui ar ambiente, fácil de usar em lugares remotos, estabilidade cardiovascular e boa qualidade de recuperação. O propofol, devido sua farmacologia, é um dos fármacos mais usados em infusões contínuas. Recentes avanços têm acontecido na anestesia venosa total com a utilização de infusões alvo controlada, baseados em simulações farmacodinâmicas e farmacocinéticas dos fármacos em tempo real, inclusive na Medicina Veterinária. Em função disso, pretendeu-se colocar em prática este tipo de anestesia, utilizando-a em cadelas para a realização de cirurgias de ovariosalpingohisterectomia. Para isso foram anestesiadas 20 cadelas, após o consentimento livre e esclarecido dos proprietários. Sendo divididos em dois grupos (GI e GII). Em GI, os animais foram pré-tratados com levomepromazina na dose de 0,5mg/kg IV e anestesiados com propofol por infusão alvo controlada na dose de indução de 3,5æg/ml e na dose de manutenção de 1,5 æg/ml IV, através bomba de infusão Harvard pump, associado com remifentanila na dose de 0,3æg/kg/min, através de bomba de seringa. Em GII, os animais receberam o mesmo tratamento de GI, só que ao invés de receberem o propofol por infusão alvo controlada, receberam o propofol a 5mg/kg como dose de indução e como manutenção, receberam o propofol em infusão contínua de velocidade fixa, na dose de 0,2mg/kg/min. Assim, compararam-se as duas técnicas de infusão, a de velocidade fixa e a alvo controlada, concluindo-se que as doses de propofol utilizadas em ambas as técnicas, após o pré-tratamento de levomepromazina e associadas ao opióide, foram eficazes para a realização cirúrgica, promovendo bradicardia e discreta hipotensão, porém estabilidade hemogasométrica e respiratória...
Total venous anesthesia has many advantages as it does not pollute environmental air, can be easily used in remote sites, provides cardiovascular stability and good recovery quality. Due to its pharmacology, propofol is one of the most frequently used drugs in continuous infusions. Recently, advances have also been observed in total venous anesthesia with the use of target-controlled infusions based on real-time pharmacodynamic and pharmacokinetic drug simulations in Veterinary Medicine. As a result, this study aimed at applying this type of anesthesia by using it in female dogs for the performance of ovariosalpingohysterectomy surgery. To that end, twenty female dogs were anesthetized after free consent was given by their owners. The animals were divided into two groups (GI and GII). In GI, the dogs were pre-treated with methotrimeprazine at a dose of 0.5mg/kg IV and anesthetized with propofol by target-controlled infusion at an induction dose of 3.5æg/ml and a maintenance dose of 1.5 æg/ml IV by means of a Harvard infusion pump associated with remifentanil at a dose of 0.3æg/kg/min by means of a syringe pump. In GII, the animals received the same treatment as that given to GI, except that instead of receiving propofol by target-controlled infusion, they were given propofol at 5mg/kg as an induction dose. As maintenance, they received propofol by single-speed continuous infusion at a dose of 0.2mg/kg/min. Hence, two infusion techniques, fixed-speed infusion and target-controlled infusion, were compared, leading to the conclusion that the doses of propofol used in both techniques, after pre-treated with methotrimeprazine, associated with the opioid were efficient for surgery performance as they promoted bradycardia and discreet hypotension, but hemogasometric and respiratory stability, futher good muscle relaxation, more evident in fixed-speed infusion... (Complete abstract click electronic access below)
Total venous anesthesia has many advantages as it does not pollute environmental air, can be easily used in remote sites, provides cardiovascular stability and good recovery quality. Due to its pharmacology, propofol is one of the most frequently used drugs in continuous infusions. Recently, advances have also been observed in total venous anesthesia with the use of target-controlled infusions based on real-time pharmacodynamic and pharmacokinetic drug simulations in Veterinary Medicine. As a result, this study aimed at applying this type of anesthesia by using it in female dogs for the performance of ovariosalpingohysterectomy surgery. To that end, twenty female dogs were anesthetized after free consent was given by their owners. The animals were divided into two groups (GI and GII). In GI, the dogs were pre-treated with methotrimeprazine at a dose of 0.5mg/kg IV and anesthetized with propofol by target-controlled infusion at an induction dose of 3.5æg/ml and a maintenance dose of 1.5 æg/ml IV by means of a Harvard infusion pump associated with remifentanil at a dose of 0.3æg/kg/min by means of a syringe pump. In GII, the animals received the same treatment as that given to GI, except that instead of receiving propofol by target-controlled infusion, they were given propofol at 5mg/kg as an induction dose. As maintenance, they received propofol by single-speed continuous infusion at a dose of 0.2mg/kg/min. Hence, two infusion techniques, fixed-speed infusion and target-controlled infusion, were compared, leading to the conclusion that the doses of propofol used in both techniques, after pre-treated with methotrimeprazine, associated with the opioid were efficient for surgery performance as they promoted bradycardia and discreet hypotension, but hemogasometric and respiratory stability, futher good muscle relaxation, more evident in fixed-speed infusion... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Anestesia, Anestesicos, Anestesia alvo-controlada, Infusão contínua, Target-controlled anesthesia, Continuous infusion
Como citar
HATSCHBACH, Eduardo. Estudo comparativo entre anestesia venosa total alvo-controlada e por infusão contínua em cães pré-tratados com levomepromazina e tratados com propofol e remifentanila. 2007. 119 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.