Opióides sim ou não, eis a questão: estudo prospetivo de comparação de protocolos anestésicos com e sem opióides em ovariohisterectomia de cadelas
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2020
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Os opióides têm sido a base da anestesia e do controlo de dor, tanto em Medicina
Humana como Veterinária. A anestesia livre de opióides é uma prática descrita e relativamente
recente em Medicina Veterinária, mas com resultados positivos.
Pretendeu-se com o presente estudo prospetivo, avaliar a viabilidade de utilização de
um protocolo anestésico sem opióides, em ovariohisterectomia de cadelas saudáveis,
comparando com um protocolo com metadona, utilizado rotineiramente na prática clínica.
Avaliou-se também a eficácia analgésica intra e pós cirúrgica em ambos os protocolos. Para tal,
criaram-se dois grupos de estudo com 10 animais cada - grupo GLKD, no qual se administrou
lidocaína, ketamina e dexmedetomidina em bólus inicial seguido de uma infusão contínua;
grupo GM no qual se administrou dexmedetomidina e metadona em dose única. Para a
comparação, avaliaram-se em determinados momentos as variáveis frequência cardíaca,
pressão arterial sistólica, pressão arterial média, tempo de extubação, frequência de resgates
analgésicos e ocorrência de náusea e/ou vómito em ambos os grupos. A avaliação da dor no
período pós-cirúrgico foi realizada através do preenchimento de duas escalas de dor.
Com a realização deste trabalho, verificou-se que ambos o protocolos são válidos,
apresentando analgesia adequada tanto no período intra-cirúrgico como no pós-cirúrgico. O
grupo GLKD não apresentou bradicardia nem hipotensão intra-cirúrgica.
Opioids have been the basis of anesthesia and pain control, both in Human and Veterinary Medicine. Opioid-free anesthesia is a described practice and relatively recent in Veterinary Medicine, but with positive results. The aim of this prospective study was to evaluate the feasibility of using an anesthetic protocol without opioids in ovariohysterectomy for healthy dogs, comparing it with a protocol with methadone, used routinely in clinical practice. The intra and post-surgical analgesic efficacy was also assessed in both protocols. For this, two study groups were created with 10 animals each - GLKD group, in which lidocaine, ketamine and dexmedetomidine were administered with an initial bolus followed by a continuous rate infusion; GM group in which dexmedetomidine and methadone were administered in a single dose. For comparison, the variables heart rate, systolic blood pressure, mean blood pressure, extubation time, frequency of analgesic rescues and nausea and / or vomiting in both groups were evaluated at certain times. Pain assessment in the post-surgical period was performed by completing two pain scales. With this work, it was found that both protocols are valid, presenting adequate analgesia both in the intra-surgical and in the post-surgical period. The GLKD group did not present bradycardia nor hypotension intra-surgical.
Opioids have been the basis of anesthesia and pain control, both in Human and Veterinary Medicine. Opioid-free anesthesia is a described practice and relatively recent in Veterinary Medicine, but with positive results. The aim of this prospective study was to evaluate the feasibility of using an anesthetic protocol without opioids in ovariohysterectomy for healthy dogs, comparing it with a protocol with methadone, used routinely in clinical practice. The intra and post-surgical analgesic efficacy was also assessed in both protocols. For this, two study groups were created with 10 animals each - GLKD group, in which lidocaine, ketamine and dexmedetomidine were administered with an initial bolus followed by a continuous rate infusion; GM group in which dexmedetomidine and methadone were administered in a single dose. For comparison, the variables heart rate, systolic blood pressure, mean blood pressure, extubation time, frequency of analgesic rescues and nausea and / or vomiting in both groups were evaluated at certain times. Pain assessment in the post-surgical period was performed by completing two pain scales. With this work, it was found that both protocols are valid, presenting adequate analgesia both in the intra-surgical and in the post-surgical period. The GLKD group did not present bradycardia nor hypotension intra-surgical.
Descrição
Orientação: Lénio Ribeiro ; co-orientação: Diogo Santos
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, CÃES, OVARIOHISTERECTOMIA, VETERINARY MEDICINE, DOGS, OVARIOHYSTERECTOMY, ANESTESIA VETERINÁRIA, VETERINARY ANAESTHESIA