Incidência e tratamento da hipotensão após anestesia epidural em cães

Detalhes bibliográficos
Autor(a) principal: Mortate, Louise Pereira
Data de Publicação: 2015
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFG
dARK ID: ark:/38995/0013000005nw2
Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/9604
Resumo: Epidural anesthesia is a safe technique when performed correctly. However, complications like hypotension are common and can be intensified by dorsal recumbence since the caudal vena cava is compressed. This study intended to determine the incidence and intensity of arterial hypotension after epidural anesthesia with lidocaine and morphine, as well as identify whether the change to dorsal recumbence may potentiate the hypotensive effect of epidural anesthesia. The efficacy of the treatment with Ringer lactate, 6% hydroxyethyl starch 130/04 or ephedrine was also compared. Forty-five dogs undergoing ovariohysterectomy, orchiectomy or lumpectomy were included in the study. The animals were premedicated with acepromazine (0.03 mg/kg) and pethidine (3 mg/kg, IM) and the anesthesia was induced with midazolam (0.1 mg/kg) and propofol, IV. Superficial plane of anesthesia was maintained with isoflurane and after 15 minutes the dogs received epidural anesthesia with 1% morphine (0.1 mg/kg) and 2% lidocaine without vasoconstrictor to a final volume of 1 mL/4.5 kg. Heart rate (FC), systolic blood pressure (PAS), respiratory rate (f), peripheral oxyhemoglobin saturation (SPO2), end-tidal CO2 (ETCO2), and body temperature (CT) were evaluated. In a pilot study, 12 animals were used to verify the occurrence of hypotension and to adjust the experimental protocol (CG, n = 12). The animals with hypotension were treated with Ringer lactate (GRL, n = 10), 20 mL/kg, administered in 15 minutes; hydroxyethyl starch 130/04 6% (GHA, n = 11), 7 mL/kg, administered in 15 minutes; or ephedrine (GEF n = 12), 0.07 mg/kg, administered as a IV bolus. After 15 minutes of epidural anesthesia, patients were positioned in dorsal recumbence and the PAS was measured during 15 minutes. It was considered hypotension when SBP < 80 mmHg or decreased > 20% from basal value (baseline). The overall incidence of hypotension induced by epidural anesthesia was 31.11% (14/45) and by the dorsal recumbence was 28.88% (13/45). None of the animals that were hypotensive after epidural anesthesia (4/10 in GRL, 4/11 in GHA and 6/12 in GEF) responded to the treatment in GRL, three responded in the GHA, and six responded in the GEF (6/12). It was concluded that hypotension after epidural anesthesia in dogs is frequent, and can be enhanced by changing the position to dorsal recumbence, Hydroxyethyl starch 130/04 and ephedrine were more effective in the treatment of this complication.
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spelling Moreno, Juan Carlos Duquehttp://lattes.cnpq.br/8509640024284103Souza, Luiz Augusto dehttp://lattes.cnpq.br/9992098510985714Moreno, Juan Carlos DuqueOleskovicz, NilsonFranco, Leandro Guimarãeshttp://lattes.cnpq.br/0443771012649662Mortate, Louise Pereira2019-05-13T13:10:55Z2015-04-30MORTATE, L. P. Incidência e tratamento da hipotensão após anestesia epidural em cães. 2015. 50 f. Dissertação (Mestrado em Ciência Animal) - Universidade Federal de Goiás, Goiânia, 2015.http://repositorio.bc.ufg.br/tede/handle/tede/9604ark:/38995/0013000005nw2Epidural anesthesia is a safe technique when performed correctly. However, complications like hypotension are common and can be intensified by dorsal recumbence since the caudal vena cava is compressed. This study intended to determine the incidence and intensity of arterial hypotension after epidural anesthesia with lidocaine and morphine, as well as identify whether the change to dorsal recumbence may potentiate the hypotensive effect of epidural anesthesia. The efficacy of the treatment with Ringer lactate, 6% hydroxyethyl starch 130/04 or ephedrine was also compared. Forty-five dogs undergoing ovariohysterectomy, orchiectomy or lumpectomy were included in the study. The animals were premedicated with acepromazine (0.03 mg/kg) and pethidine (3 mg/kg, IM) and the anesthesia was induced with midazolam (0.1 mg/kg) and propofol, IV. Superficial plane of anesthesia was maintained with isoflurane and after 15 minutes the dogs received epidural anesthesia with 1% morphine (0.1 mg/kg) and 2% lidocaine without vasoconstrictor to a final volume of 1 mL/4.5 kg. Heart rate (FC), systolic blood pressure (PAS), respiratory rate (f), peripheral oxyhemoglobin saturation (SPO2), end-tidal CO2 (ETCO2), and body temperature (CT) were evaluated. In a pilot study, 12 animals were used to verify the occurrence of hypotension and to adjust the experimental protocol (CG, n = 12). The animals with hypotension were treated with Ringer lactate (GRL, n = 10), 20 mL/kg, administered in 15 minutes; hydroxyethyl starch 130/04 6% (GHA, n = 11), 7 mL/kg, administered in 15 minutes; or ephedrine (GEF n = 12), 0.07 mg/kg, administered as a IV bolus. After 15 minutes of epidural anesthesia, patients were positioned in dorsal recumbence and the PAS was measured during 15 minutes. It was considered hypotension when SBP < 80 mmHg or decreased > 20% from basal value (baseline). The overall incidence of hypotension induced by epidural anesthesia was 31.11% (14/45) and by the dorsal recumbence was 28.88% (13/45). None of the animals that were hypotensive after epidural anesthesia (4/10 in GRL, 4/11 in GHA and 6/12 in GEF) responded to the treatment in GRL, three responded in the GHA, and six responded in the GEF (6/12). It was concluded that hypotension after epidural anesthesia in dogs is frequent, and can be enhanced by changing the position to dorsal recumbence, Hydroxyethyl starch 130/04 and ephedrine were more effective in the treatment of this complication.A anestesia epidural é uma técnica segura quando realizada de forma correta. No entanto, não é isenta de complicações, sendo uma das mais comuns a hipotensão arterial, que pode ser intensificada pelo decúbito dorsal devido à compressão da veia cava caudal. Neste estudo objetivou-se determinar a incidência e intensidade da hipotensão arterial após anestesia epidural com lidocaína e morfina, bem como identificar se a mudança para decúbito dorsal tem efeito potencializador da hipotensão. Também foi comparada a eficácia do tratamento da hipotensão utilizando-se Ringer com lactato, hidroxietilamido 130/04 a 6% ou efedrina. Foram usados 45 cães submetidos a ovariohisterectomia, orquiectomia ou nodulectomia. Os animais foram premedicados com acepromazina (0,03 mg/kg) e petidina (3 mg/kg, IM), induzidos com midazolam (0,1 mg/kg) e propofol a efeito, ambos IV e mantidos em anestesia inalatória com isoflurano, no plano II do estágio III do esquema de Guedel e, após 15 minutos de estabilização, os cães receberam anestesia epidural com morfina a 1% (0,1 mg/kg) e lidocaína a 2% sem vasoconstritor para um volume final de 1 mL/4,5 kg. Foram avaliadas a frequência (FC) e ritmo cardíacos (ECG), pressão arterial sistólica (PAS), frequência respiratória (f), saturação periférica da oxihemoglobina (SPO2), pressão parcial de CO2 no final da expiração (ETCO2) e a temperatura corpórea (TC). Em estudo piloto, foram usados 12 animais para verificar a ocorrência de hipotensão e ajustar o protocolo experimental (GC, n = 12). Os animais que apresentaram hipotensão foram tratados com Ringer lactato (GRL, n = 10), 20 mL/kg, administrados em 15 minutos; hidroxietilamido 130/04 a 6% (GHA, n = 11), 7 mL/kg, administrados em 15 minutos; ou efedrina (GEF, n = 12), 0,07 mg/kg, IV, administrada em bolus. Após 15 minutos da anestesia epidural ou de realizado o tratamento, os pacientes foram posicionados em decúbito dorsal e a PAS foi aferida por mais 15 minutos. Em caso de hipotensão os animais foram tratados de acordo com o grupo ao qual pertenciam. Considerou-se hipotensão quando a PAS < 80 mmHg ou diminuiu > 20% do valor basal. A incidência global de hipotensão induzida pela anestesia epidural foi de 31,11% (14/45) e pelo decúbito de 28,88% (13/45). Dos animais que ficaram hipotensos após a anestesia epidural (GRL 4/10, GHA 4/11 e GEF 6/12) nenhum respondeu ao tratamento no GRL, três responderam no GHA e seis responderam no GEF (6/12). Concluiu-se que a hipotensão após anestesia epidural em cães é frequente, pode ser potencializada pela mudança de posição para decúbito dorsal e que o hidroxietilamido 130/04 a 6% e a efedrina foram o mais eficazes no tratamento dessa complicação.Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2019-05-13T12:45:44Z No. of bitstreams: 2 Dissertação - Louise Pereira Mortate - 2015.pdf: 1705739 bytes, checksum: cb34c9fe2b0bebcbc364acaf7772e821 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2019-05-13T13:10:54Z (GMT) No. of bitstreams: 2 Dissertação - Louise Pereira Mortate - 2015.pdf: 1705739 bytes, checksum: cb34c9fe2b0bebcbc364acaf7772e821 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2019-05-13T13:10:55Z (GMT). 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dc.title.eng.fl_str_mv Incidência e tratamento da hipotensão após anestesia epidural em cães
dc.title.alternative.eng.fl_str_mv Incidence and treatment of epidural anesthesia after anesthesia in dogs
title Incidência e tratamento da hipotensão após anestesia epidural em cães
spellingShingle Incidência e tratamento da hipotensão após anestesia epidural em cães
Mortate, Louise Pereira
Efedrina
Hidroxietilamido
Ringer lactato
Decúbito dorsal
Hematócrito
Ephedrine
Hydroxyethyl starch
Ringer lactate
Dorsal decubitus
Hematocrit
MEDICINA VETERINARIA::PATOLOGIA ANIMAL
title_short Incidência e tratamento da hipotensão após anestesia epidural em cães
title_full Incidência e tratamento da hipotensão após anestesia epidural em cães
title_fullStr Incidência e tratamento da hipotensão após anestesia epidural em cães
title_full_unstemmed Incidência e tratamento da hipotensão após anestesia epidural em cães
title_sort Incidência e tratamento da hipotensão após anestesia epidural em cães
author Mortate, Louise Pereira
author_facet Mortate, Louise Pereira
author_role author
dc.contributor.advisor1.fl_str_mv Moreno, Juan Carlos Duque
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/8509640024284103
dc.contributor.advisor-co1.fl_str_mv Souza, Luiz Augusto de
dc.contributor.advisor-co1Lattes.fl_str_mv http://lattes.cnpq.br/9992098510985714
dc.contributor.referee1.fl_str_mv Moreno, Juan Carlos Duque
dc.contributor.referee2.fl_str_mv Oleskovicz, Nilson
dc.contributor.referee3.fl_str_mv Franco, Leandro Guimarães
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/0443771012649662
dc.contributor.author.fl_str_mv Mortate, Louise Pereira
contributor_str_mv Moreno, Juan Carlos Duque
Souza, Luiz Augusto de
Moreno, Juan Carlos Duque
Oleskovicz, Nilson
Franco, Leandro Guimarães
dc.subject.por.fl_str_mv Efedrina
Hidroxietilamido
Ringer lactato
Decúbito dorsal
Hematócrito
topic Efedrina
Hidroxietilamido
Ringer lactato
Decúbito dorsal
Hematócrito
Ephedrine
Hydroxyethyl starch
Ringer lactate
Dorsal decubitus
Hematocrit
MEDICINA VETERINARIA::PATOLOGIA ANIMAL
dc.subject.eng.fl_str_mv Ephedrine
Hydroxyethyl starch
Ringer lactate
Dorsal decubitus
Hematocrit
dc.subject.cnpq.fl_str_mv MEDICINA VETERINARIA::PATOLOGIA ANIMAL
description Epidural anesthesia is a safe technique when performed correctly. However, complications like hypotension are common and can be intensified by dorsal recumbence since the caudal vena cava is compressed. This study intended to determine the incidence and intensity of arterial hypotension after epidural anesthesia with lidocaine and morphine, as well as identify whether the change to dorsal recumbence may potentiate the hypotensive effect of epidural anesthesia. The efficacy of the treatment with Ringer lactate, 6% hydroxyethyl starch 130/04 or ephedrine was also compared. Forty-five dogs undergoing ovariohysterectomy, orchiectomy or lumpectomy were included in the study. The animals were premedicated with acepromazine (0.03 mg/kg) and pethidine (3 mg/kg, IM) and the anesthesia was induced with midazolam (0.1 mg/kg) and propofol, IV. Superficial plane of anesthesia was maintained with isoflurane and after 15 minutes the dogs received epidural anesthesia with 1% morphine (0.1 mg/kg) and 2% lidocaine without vasoconstrictor to a final volume of 1 mL/4.5 kg. Heart rate (FC), systolic blood pressure (PAS), respiratory rate (f), peripheral oxyhemoglobin saturation (SPO2), end-tidal CO2 (ETCO2), and body temperature (CT) were evaluated. In a pilot study, 12 animals were used to verify the occurrence of hypotension and to adjust the experimental protocol (CG, n = 12). The animals with hypotension were treated with Ringer lactate (GRL, n = 10), 20 mL/kg, administered in 15 minutes; hydroxyethyl starch 130/04 6% (GHA, n = 11), 7 mL/kg, administered in 15 minutes; or ephedrine (GEF n = 12), 0.07 mg/kg, administered as a IV bolus. After 15 minutes of epidural anesthesia, patients were positioned in dorsal recumbence and the PAS was measured during 15 minutes. It was considered hypotension when SBP < 80 mmHg or decreased > 20% from basal value (baseline). The overall incidence of hypotension induced by epidural anesthesia was 31.11% (14/45) and by the dorsal recumbence was 28.88% (13/45). None of the animals that were hypotensive after epidural anesthesia (4/10 in GRL, 4/11 in GHA and 6/12 in GEF) responded to the treatment in GRL, three responded in the GHA, and six responded in the GEF (6/12). It was concluded that hypotension after epidural anesthesia in dogs is frequent, and can be enhanced by changing the position to dorsal recumbence, Hydroxyethyl starch 130/04 and ephedrine were more effective in the treatment of this complication.
publishDate 2015
dc.date.issued.fl_str_mv 2015-04-30
dc.date.accessioned.fl_str_mv 2019-05-13T13:10:55Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv MORTATE, L. P. Incidência e tratamento da hipotensão após anestesia epidural em cães. 2015. 50 f. Dissertação (Mestrado em Ciência Animal) - Universidade Federal de Goiás, Goiânia, 2015.
dc.identifier.uri.fl_str_mv http://repositorio.bc.ufg.br/tede/handle/tede/9604
dc.identifier.dark.fl_str_mv ark:/38995/0013000005nw2
identifier_str_mv MORTATE, L. P. Incidência e tratamento da hipotensão após anestesia epidural em cães. 2015. 50 f. Dissertação (Mestrado em Ciência Animal) - Universidade Federal de Goiás, Goiânia, 2015.
ark:/38995/0013000005nw2
url http://repositorio.bc.ufg.br/tede/handle/tede/9604
dc.language.iso.fl_str_mv por
language por
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dc.relation.confidence.fl_str_mv 600
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dc.relation.sponsorship.fl_str_mv -2555911436985713659
dc.rights.driver.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Goiás
dc.publisher.program.fl_str_mv Programa de Pós-graduação em Ciência Animal (EVZ)
dc.publisher.initials.fl_str_mv UFG
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Escola de Veterinária e Zootecnia - EVZ (RG)
publisher.none.fl_str_mv Universidade Federal de Goiás
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFG
instname:Universidade Federal de Goiás (UFG)
instacron:UFG
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