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Anestesia local por tumesc?ncia com lidoca?na em gatas submetidas a mastectomia / Tumescent local anesthesia with lidocaine in cats to submitted mastectomy

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Previous issue date: 2016-02-26 / The tumescent anesthesia technique has excelled for ensuring effective analgesia. This technique is capable to decrease the volatile anesthetic application. The aim of this study was to evaluate the tumescent technique using lidocaine in cats submitted to mastectomy, by measuring plasma lidocaine concentrations, and evaluation of analgesia postoperatively. Twelve female cats with mammary tumors were selected without predilection for weight or age. All animals received on pre anesthetic medication, intramuscular pethidine 4 mg.kg-1. After 15 minutes, the surgical site, cephalic and jugular veins were clipped. An intravenous (IV) catheter was introduced into cephalic vein for administration of saline solution. Anesthesia was induced with propofol (5 mg.kg-1) followed by endotracheal intubation and, was maintained with isoflurane. The Klein cannula (2,0 mm x 14 cm) was used to provide dispersion of refrigerated tumescent solution. The tumescent solution was prepared with 210 mL of lactate Ringer?s solution, 0,5 mL of adrenaline and 40 mL of 2% lidocaine, without vasoconstrictor, to achieve a lidocaine concentration of 0,32%. The local anesthetic solution (15 mL.kg-1 at 8?C) was injected under extension of the target mammary glands. The physiological variables [heart rates (FC), respiratory rates (f), systolic arterial blood pressures (PAS), retal temperature, oximetry (SpO2), capnography (EtCO2)] and anesthetic gases expired were measured, throughout the entire procedure. Blood samples were serially collected for measurement of the plasma lidocaine concentration, through High Performance Liquid Chromatography (HPLC). After the surgical procedure the animals had their pain scores assessed at one-hour intervals through a multidimensional scale during six hours. The anesthetic recovery was performed with tramadol, 2 mg.kg-1 (IM) associated to meloxicam 0,15 mg.kg-1 subcutaneously. The plasmatic peak lidocaine was achieved at 90 minutes after infiltration, and it did not produce toxic levels of plasma lidocaine concentrations. Analgesic rescue was performed at median time of 6 hours after infiltration of the tumescent solution. In conclusion, lidocaine tumescent anesthesia is effective to promote satisfactory intraoperative and postoperative analgesia, and is safe for use in cats without interfering on time to stiches removal. / A t?cnica de anestesia por tumesc?ncia tem se destacado por garantir analgesia eficaz, sendo capaz de diminuir o requerimento do anest?sico vol?til. O presente estudo visou avaliar a t?cnica de tumesc?ncia com lidoca?na para mastectomia em gatas, atrav?s da mensura??o das concentra??es plasm?ticas do f?rmaco e o tempo de analgesia p?s-operat?ria. Foram selecionadas 12 gatas com tumores mam?rios sem restri??es quanto ao peso e a idade. Todos os animais receberam como medica??o pr?-anest?sica, meperidina 4 mg.kg-1 pela via intramuscular (IM), e ap?s 15 minutos foi realizada a tricotomia da regi?o mam?ria e das veias cef?lica e jugular. Ap?s pun??o da veia cef?lica, foi realizada indu??o com o f?rmaco propofol (5 mg.kg-1) pela via intravenosa (IV) e em seguida a intuba??o orotraqueal e manuten??o anest?sica com isoflurano. Foi utilizada uma c?nula de Klein, com 2,0 mm x 14 cm, para infiltra??o da solu??o tumescente refrigerada com temperatura de aproximadamente 8?C. Esta solu??o foi composta por 210 mL de solu??o de ringer com lactato, 0,5 mL de adrenalina e 40 mL de lidoca?na a 2% sem vasoconstritor, resultando em uma solu??o anest?sica local a 0,32%. A tumesc?ncia foi aplicada com volume fixo de infiltra??o de 15 mL.kg-1 para todos os animais. As vari?veis fisiol?gicas [frequ?ncia card?aca (FC), frequ?ncia respirat?ria (f), press?o arterial sist?lica (PAS), temperatura retal, oximetria (SpO2), capnografia (EtCO2)] e gases anest?sicos expirados foram avaliadas durante todo o procedimento. Foram coletadas amostras de sangue seriadas para mensura??o da concentra??o plasm?tica de lidoca?na atrav?s da t?cnica de cromatografia l?quida de alta performance (HPLC). Ap?s o t?rmino do procedimento cir?rgico os animais tiveram seus escores de dor avaliados em intervalos de uma hora atrav?s de uma escala multidimensional at? o tempo m?ximo de seis horas. O resgate analg?sico foi feito com 2 mg.kg-1 de cloridrato de tramadol (IM) associado ao meloxicam na dose de 0,15 mg.kg-1 pela via subcut?nea (SC). O pico plasm?tico de lidoca?na foi em 90 minutos ap?s a infiltra??o da solu??o tumesceste, e nenhum animal alcan?ou n?veis considerado t?xicos de lidoca?na para a esp?cie. O resgate analg?sico foi realizado aproximadamente seis horas ap?s a infiltra??o. Conclui-se que a anestesia por tumesc?ncia com lidoca?na ? eficaz para promover analgesia satisfat?ria nos momentos trans e p?s-operat?rios imediatos em gatas submetidas a mastectomia, sem causar risco de intoxica??o e interferir no tempo de remo??o dos pontos.

Identiferoai:union.ndltd.org:IBICT/oai:localhost:jspui/1853
Date26 February 2016
CreatorsMOREIRA, Clarissa Martins do Rio
ContributorsSouza, Heloisa Justen Moreira de, Corgozinho, Katia Bar?o, Souza, Heloisa Justen Moreira de, Fernandes, Julio Israel, Santos, Paulo Sergio Patto dos
PublisherUniversidade Federal Rural do Rio de Janeiro, Programa de P?s-Gradua??o em Medicina Veterin?ria (Patologia e Ci?ncias Cl?nicas), UFRRJ, Brasil, Instituto de Veterin?ria
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da UFRRJ, instname:Universidade Federal Rural do Rio de Janeiro, instacron:UFRRJ
Rightsinfo:eu-repo/semantics/openAccess

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