Efeitos da administração de xilazina e doxapram na recuperação de cavalos anestesiados com isofluorano
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Data
2017-08-21
Autores
Midon, Mônica [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A recuperação é uma fase crítica na anestesia de equinos. Tentativas precoces de retornar à posição quadrupedal são normalmente fracassadas podendo ocasionar quedas, injúrias e até mesmo fraturas. Técnicas para melhorar a qualidade de recuperação incluem o uso de agonistas adrenérgicos do tipo α2, os quais objetivam, neste contexto, a sedação do paciente, aumentando o tempo de decúbito e possibilitando maior tempo de eliminação do anestésico inalatório residual. O doxapram é um fármaco caracterizado por provocar aumento na frequência respiratória e, potencialmente, pode aumentar o clearance dos anestésicos inalatórios. Neste contexto, objetivou-se verificar a influência da administração dos fármacos xilazina e doxapram no tempo e na qualidade da recuperação de equinos submetidos à anestesia geral inalatória com isofluorano. Seis cavalos foram anestesiados durante 90 minutos quatro vezes, com intervalo de duas semanas entre os procedimentos, recebendo aleatoriamente os seguintes tratamentos após a interrupção do anestésico inalatório: xilazina 0,2 mg/kg, ou xilazina e doxapram (0,2 e 0,1 mg/kg, respectivamente), ou xilazina e doxapram (0,2 e 0,2 mg/kg, respectivamente), ou solução NaCl 0,9%. Todas recuperações foram filmadas e avaliadas por dois observadores não cientes dos tratamentos, por meio da escala visual analógica e escala qualitativa descritiva. Os escores foram analisados quanto à concordância por BlandAltman e quanto à diferença pela RM ANOVA, seguido pelo teste de Tukey (p < 0,05), assim como os demais parâmetros aferidos. Não houve diferença nos tempos de recuperação avaliados entre os grupos. Em relação aos escores, o grupo que recebeu apenas xilazina apresentou as melhores recuperações, seguido da dose mais alta de doxapram, grupo controle e o grupo com a dose de 0,1 mg/kg. A adição de doxapram no protocolo de re-sedação em equinos anestesiados com isoflurano não promoveu melhora qualitativa e não alterou tempo de recuperação da anestesia.
Recovery is a critical stage on equine anesthesia. Early attempts to assume upright position are seldom successful and frequently result on falls, injuries and even fractures. Techniques to improve anesthetic recovery include the use of α2- adrenergic agonists at recovery in order to increase the recumbency time permitting clearance a broader residual inhalational anesthetic. Doxapram is characterized by increasing respiratory rate. Potentially it can increase inhaled anesthetics clearence. The purpose of the present study was to verify to influence of xylazine and doxapram administration on time and quality of recovery of horses submitted to isoflurane inhalational anesthesia. Six horses were anesthetized four times, with a wash out period of two weeks. Each animal received one of the following randomized treatments following discontinuation of isoflurane anesthesia: xylazine 0.2 mg/kg, or xylazine plus doxapram (0.2 and 0.1 mg/kg, respectively), xylazine plus doxapram (0.2 and 0.2 mg/kg, respectively), or NaCl 0.9% solution. Recovery was filmed and posterior evaluated by two blind observes by a visual analogue scale and a qualitative descriptive scale. The scores were analyzed for agreement by Bland-Altman and for the difference by RM ANOVA followed by Tukey test. The parameters measured were analyzed with RM ANOVA followed by Tukey test (p < 0.05). There was no difference regarding times recovery between groups. The animals who received just xylazine presented better scores on quality analysis, followed by doxapram 0.2 mg/kg group, control group, and 0.1 mg.kg of doxapram group. The use of doxapram to re-sedate horses isoflurane anesthetized does not improve quality neither diminish time of recovery.
Recovery is a critical stage on equine anesthesia. Early attempts to assume upright position are seldom successful and frequently result on falls, injuries and even fractures. Techniques to improve anesthetic recovery include the use of α2- adrenergic agonists at recovery in order to increase the recumbency time permitting clearance a broader residual inhalational anesthetic. Doxapram is characterized by increasing respiratory rate. Potentially it can increase inhaled anesthetics clearence. The purpose of the present study was to verify to influence of xylazine and doxapram administration on time and quality of recovery of horses submitted to isoflurane inhalational anesthesia. Six horses were anesthetized four times, with a wash out period of two weeks. Each animal received one of the following randomized treatments following discontinuation of isoflurane anesthesia: xylazine 0.2 mg/kg, or xylazine plus doxapram (0.2 and 0.1 mg/kg, respectively), xylazine plus doxapram (0.2 and 0.2 mg/kg, respectively), or NaCl 0.9% solution. Recovery was filmed and posterior evaluated by two blind observes by a visual analogue scale and a qualitative descriptive scale. The scores were analyzed for agreement by Bland-Altman and for the difference by RM ANOVA followed by Tukey test. The parameters measured were analyzed with RM ANOVA followed by Tukey test (p < 0.05). There was no difference regarding times recovery between groups. The animals who received just xylazine presented better scores on quality analysis, followed by doxapram 0.2 mg/kg group, control group, and 0.1 mg.kg of doxapram group. The use of doxapram to re-sedate horses isoflurane anesthetized does not improve quality neither diminish time of recovery.
Descrição
Palavras-chave
Agonistas adrenergicos, Analeptico respiratorio, Anestesia geral inalatoria, Ataxia, Equinos, Adrenergic agonists, Ataxia, Equine, Inhalation general anesthesia, Respiratory analeptic