Os opióides têm sido utilizados em Medicina Veterinária há vários anos como alternativa para o alívio da dor
INTRODUÇÃOAtualmente, a dor pós-operatória ou pós-traumática tem sido uma das grandes preocupações dos clínicos veterinários. Freqüentemente, ela é controlada com administração de analgésicos. Nos casos de dor aguda intensa, a injeção parenteral de opióides mostra-se eficaz, apesar de essas substâncias terem vida média relativamente curta e, geralmente, serem necessárias doses repetidas para manter a analgesia, aumentando o risco do aparecimento de efeitos colaterais (THURMON et al., 1996). A analgesia epidural, com anestésicos locais, possui baixa seletividade, produzindo tanto bloqueio sensitivo como bloqueio motor, tornando esta técnica pouco atrativa para o controle da dor por períodos prolongados (KEEGAN et al., 1995;HERPERGER 1998;TORSKE et al., 1998). Recentes estudos sobre a fisiologia da dor, particularmente da dor clínica, têm fomentado o uso de agentes analgésicos opióides como importante alternativa no controle da nocicepção em animais e, principalmente por via epidural, para o controle segmentar da dor pós-operatória (POPILSKIS et al., 2000), porque produz analgesia pós-cirúrgica dosedependente de melhor qualidade e duração do que a obtida após administração desses agentes por via parenteral (ALLEN et al., 1986). Assim, nesta revisão, abordam-se vários efeitos observados após o uso e as indicações da administração epidural de opióides, em cães.
To evaluate the effects of intravenous regional limb perfusion (IRLP) administration of amphotericin B in horses to treat pythiosis after surgical excision and thermocautery.
Horses (n = 12) with Pythium insidiosum infection of the distal aspect of the thoracic or pelvic limbs.
After surgical excision of granulation tissue and thermocautery, 50 mg amphotericin B was administered by IRLP through a catheter placed in a superficial vein of the affected limb next to the lesion after placing a tourniquet above the injection site. The lesions and locomotor system were evaluated before treatment and at 7, 14, 21, 28, 35, and 60 days.
Ninety‐two percent of horses treated with amphotericin B had complete lesion resolution 35 or 60 days after 1 or 2 IRLP treatments, respectively. IRLP induced limb edema and pain during regional palpation in 42%, and inflammation of the injection site in 33% of horses; however these signs resolved after 14 days.
IRLP administration of amphotericin B was effective for treating pythiosis in equine limbs, resolving infection with manageable side effects.
Although indirect methods for estimating intra-abdominal pressure (IAP) have been extensively studied in humans, mainly for identification of IAP increments in critical care unit patients (life-threatening condition), little work has been performed in veterinary medicine, especially in horses. The standard method of acquisition of intrabladder pressure (IBP) in human subjects (fluid-filled system with no balloon distention) has been previously evaluated in horses with an unfavorable outcome. Therefore, we reexamined the previously performed method of IBP investigation in horses by using an air-filled intrabladder manometry system in female horses. Intrabladder pressure was estimated by air-filled balloon manometry in seven healthy adult mares. The results were compared with two sets of directly acquired IAP values obtained by right paralumbar puncture using an 8-G needle in seven horses. Direct IAP values were obtained at times unrelated to IBP measurement acquisitions, and three of the seven horses used (for direct IAP measurement) were different animals from the mares used for assessment of IBP. Both sets of IAP measurements yielded subatmospheric values (IAP 1 ¼ À10.5 AE 2.2 mm Hg; IAP 2 ¼ À11.6 AE 2.0 mm Hg). Slightly subatmospheric IBP values were also recorded in some mares, but the mean (AESD) IBP was 1.4 AE 2.0 mm Hg. There was no correlation between IBP and IAP. These results suggest that this indirect (IBP) method for estimating IAP is not applicable for female horses.
RESUMO Relata-se o emprego da associação da ligadura interdentária, com fio de aço (cerdagem), à resina acrílica, no tratamento de fraturas mandibulares (espaço interdental e placa alveolar) em equídeos. Observou-se o restabelecimento precoce da função mastigatória. Além disso, foi possível a reimplantação dos dentes incisivos extraídos pelo trauma. Desta forma, pode-se assegurar que a técnica mostrou-se eficiente, prática e de baixo custo.
/UNESP/Jaboticabal. email@example.com_.Ketamine, a non-competitive NMDA receptor antagonist, plays a role in inflammatory pain and has been reported to prevent central sensitization and decrease secondary hyperalgesia after skin incision. Ketamine S(+) was developed recently and has been useful in post-operative pain treatment in children. The aim of this study was therefore to evaluate the preemptive effect of epidural ketamine or ketamine S(+) administration in postincisional pain, in horses. Sixteen mixed breed females, 6(2 years old, weighting 255(45 kg, divided into G1 (ketamine S(+), n=8) and G2 (ketamine, n=8), were used. An epidural catheter was inserted between the first and the second intercoccygeal space and 15 cm cranially advanced, 24 hours before the trials. The thigh region was shaved bilaterally, and local anaesthesia (6 ml lidocaine 2%, subcutaneously) at the right side (incision side) was performed. The left side was used as control side. Twenty five minutes after lidocaine injection was administred ketamine S(+) in G1 or ketamine in G2 through the epidural catheter (1,0 mg/kg diluted with saline to a total volume of 3,4 +(BW in kg x 0,013 ml). The aplication time was standardized in 5 minutes. Five minutes after the ketamine injection, a 10 cm skin incision was made, in the local anesthesic infiltrated line, and sutured with a simple interrupted nylon suture. Mechanical hyperalgesia was mensured using von Frey filaments, at 1, 3 and 5 cm around the incision in 15 minutes intervals for 2 hours, then 4, 6 and 8 hours after suturing. Heart and respiratory rates, and temperature were also recorded. Data collected from von Frey filaments were converted in force (grams) and evaluated by non-parametric analysis (Kruskall-Wallis p( 0,05). There were no significant changes on heart and respiratory rates and temperature (Tukey Test p( 0,05). Between groups there were significant difference until T45 only. Into the groups difference was observed from T45 to T480 in the G1 animals and T60 to T480 in the G2 animals, when compared with T0. It was concluded that ketamine S(+) and ketamine have similar analgesic effect in the postincisional pain in horses.
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