Estudo da associação da lidocaína na venografia distal do membro torácico de equinos hígidos
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Data
2019-09-20
Autores
Melo Neto, Gabriel Barbosa
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A venografia é um exame radiográfico contrastado utilizado para identificar ou avaliar a função venosa de membros, órgãos ou região anatômica. A lidocaína é um anestésico local que possui efeito vasodilatador. O objetivo do trabalho foi avaliar o efeito da lidocaína (2%), na venografia distal do membro torácico de equinos hígidos, por meio da descrição e contagem dos vasos contrastados distalmente ao membro, comparou-se a aplicação de 40 mL de contraste diatrizoato de meglumina 60% associado à lidocaína 2% com a associação de solução salina 0,9% e os volumes entre 40 e 60 mL de solução, questionando-se se a variação de volume ou a associação com a lidocaína pela vasodilatação podem diferir sobre no preenchimento venoso. Em cinco equinos adultos hígidos procedeu-se a venografia em ambos os membros torácicos com estase a partir de torniquete aplicado na região distal do rádio, aplicando-se para cada membro torácico os protocolos 40S (20 mL de meio de contraste + 20 mL de solução salina 0,9%), 40L (20 mL de meio de contraste + 20 mL de lidocaína 2%) e 60S (30 mL de meio de contraste + 30 mL de solução salina 0,9%) com intervalo de cinco dias entre cada exame. Os exames radiográficos foram realizados nas projeções dorso-palmar (DPa) e látero-medial (LM) (70 kV, 8 mAs e 70 cm distância foco-filme). As medianas foram calculadas a partir da contagem de vasos nas duas posições radiográficas e nas regiões distal de metacarpo e média das falanges proximal e média. Foi observado a distribuição axial até a falange distal em todos os protocolos, com mais evidente visualização dos vasos mais calibrosos nos protocolos que foi usada a lidocaína. Os protocolos não apresentaram diferença expressiva no número de vasos visibilizados. Para o protocolo 40S as medianas dos vasos observados na projeção DPa foram 6, 5 e 13,5 vasos nas regiões distal de metacarpo, falange proximal e falange média; nas mesmas regiões na projeção LM a mediana observada foi de 7, 4,5 e 12,5 vasos. Para o protocolo 40L as medianas dos vasos observados na projeção DPa foram 5, 2 e 9 vasos nas regiões distal de metacarpo, falange proximal e falange média; nas mesmas regiões na projeção LM foram observados 5, 3 e 7,5 vasos. Para o protocolo 60S as medianas dos vasos observados na projeção DPa foram 6,5, 2,5 e 11 vasos nas regiões distal de metacarpo, falange proximal e falange média; nas mesmas regiões na projeção LM foram observados 6, 4 e 11 vasos. Os diferentes volumes de solução associado ou não a lidocaína foram eficazes em perfundir os vasos do casco. Não houve diferença marcante entre os protocolos. A lidocaína a 2% sem vasoconstrictor associada a venografia no membro distal de equinos hígidos sugeriu promover vasodilatação, porém sem elevar o número de vasos visualizados.
Venography is a contrasted radiographic examination used to identify or evaluate venous function in limbs, organs or other anatomic regions. Lidocaine is a local anesthetic that has a vasodilator effect. The aim of this study was to evaluate the effect of lidocaine (2%), in the distal venography of the distal forelimb of horses, through the description and counting of regional distal vessels, comparing the application of contrast solution associated with lidocaine and saline solution in total volumes of 40 or 60 mL, aiming to evaluate whether the volume variation or the association with lidocaine would interfere in the results. Venography was performed on both forelimbs of five adult horses, with stasis from a tourniquet applied to the distal radius, applying three different combinations of fluids: group 40S received 20 mL of contrast + 20 mL of saline solution 0,9%; group 40L received 20 mL of contrast + 20 mL of lidocaine 2% and group 60S received 30 mL de contrast + 30 mL of solution saline 0,9%. An interval of five days between every utilization was respected. The radiographs were made in the dorsopalmar and lateromedial projections (70kV, 8 mA and 70 cm of distance). The medians were calculated using the vessel count of both radiographic projections, in the distal metacarpal and middle regions of the proximal and middle phalanges. Axial distribution to the distal phalanx was observed in all protocols, with more evidence of the larger caliber of the vessels when lidocaine was used. There was no statistical difference between the numbers of vessels in all the protocols. The median values in the 40S group were 6, 5 and 13.5 vessels in the distal metacarpal, proximal phalanx and middle phalanx regions, respectively; the lateromedial projection of the same regions showed 7, 4.5 and 12.5 vessels. For the 40L protocol the median values in the dorsopalmar projection were 5, 2 and 9 vessels in the distal metacarpal, proximal phalanx and middle phalanx regions, whereas the lateromedial projection evidenced 5, 3 and 7.5 vessels. The 60S protocol presented medians of 6.5, 2.5 and 11 vessels in the dorsopalmar projection of distal metacarpal, proximal phalanx and middle phalanx regions, and 6, 4 and 11 vessels were observed in the lateromedial projection. All the protocols were efficient for filling hoof vessels, presenting no statistical difference between the protocols. Lidocaine 2% without vasoconstrictor caused a slight vasodilation, but without increasing the number of visible vessels.
Venography is a contrasted radiographic examination used to identify or evaluate venous function in limbs, organs or other anatomic regions. Lidocaine is a local anesthetic that has a vasodilator effect. The aim of this study was to evaluate the effect of lidocaine (2%), in the distal venography of the distal forelimb of horses, through the description and counting of regional distal vessels, comparing the application of contrast solution associated with lidocaine and saline solution in total volumes of 40 or 60 mL, aiming to evaluate whether the volume variation or the association with lidocaine would interfere in the results. Venography was performed on both forelimbs of five adult horses, with stasis from a tourniquet applied to the distal radius, applying three different combinations of fluids: group 40S received 20 mL of contrast + 20 mL of saline solution 0,9%; group 40L received 20 mL of contrast + 20 mL of lidocaine 2% and group 60S received 30 mL de contrast + 30 mL of solution saline 0,9%. An interval of five days between every utilization was respected. The radiographs were made in the dorsopalmar and lateromedial projections (70kV, 8 mA and 70 cm of distance). The medians were calculated using the vessel count of both radiographic projections, in the distal metacarpal and middle regions of the proximal and middle phalanges. Axial distribution to the distal phalanx was observed in all protocols, with more evidence of the larger caliber of the vessels when lidocaine was used. There was no statistical difference between the numbers of vessels in all the protocols. The median values in the 40S group were 6, 5 and 13.5 vessels in the distal metacarpal, proximal phalanx and middle phalanx regions, respectively; the lateromedial projection of the same regions showed 7, 4.5 and 12.5 vessels. For the 40L protocol the median values in the dorsopalmar projection were 5, 2 and 9 vessels in the distal metacarpal, proximal phalanx and middle phalanx regions, whereas the lateromedial projection evidenced 5, 3 and 7.5 vessels. The 60S protocol presented medians of 6.5, 2.5 and 11 vessels in the dorsopalmar projection of distal metacarpal, proximal phalanx and middle phalanx regions, and 6, 4 and 11 vessels were observed in the lateromedial projection. All the protocols were efficient for filling hoof vessels, presenting no statistical difference between the protocols. Lidocaine 2% without vasoconstrictor caused a slight vasodilation, but without increasing the number of visible vessels.
Descrição
Palavras-chave
Angiografia, Perfusão intravenosa regional, Vasodilatação, Venograma, Angiography, Regional intravenous limb perfusion, Vasodilation, Venogram