Background: The South American coatis (Nasua nasua) are capable of adapting to different habitats, which allowed them to exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this species demand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as well as rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to report the use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasua submitted to osteosynthesis of the radius and caudectomy due to trauma.Case: A adult male coati weighing 2.3 kg was referred to the Veterinary Medical Teaching Hospital of the Universidade Federal do Paraná (UFPR) - Setor Palotina with a history of trauma. Physical examination showed crackling in the radius and ulnar region, and also abnormal angulation in the distal portion of the tail. After taking x-rays, fractures were confirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of water and food withdrawal, the animal was premedicated with a combination of ketamine (10 mg/kg), midazolam (0.3 mg/kg) and methadone (0.2 mg/kg), intramuscularly (IM). Induction of anesthesia was performed with propofol titrated to effect (total dose 4 mg/kg) and anesthesia was maintained with isoflurane in spontaneous ventilation using a non-rebreathing circuit (Baraka). It was evaluated heart rate (HR), respiratory rate (RF), end-tidal CO2 (EtCO2), expired isoflurane fraction (FE´Iso), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral recumbence. A subscapular brachial plexus block was performed with bupivacaine (0.2 mL/kg) using a peripheral nerve stimulator to ensure the correct perineural deposition of the local anesthetic. During anesthesia, rescue analgesia was administered when there was a 20% increase in HR, RR or SBP compared to baseline values. Thus, in this case, two rescues with fentanyl (2 µg/kg) were necessary. The animal remained stable and, at the end of the first procedure, he was placed in ventral recumbence, with the hindlimbs pulled cranially in order to locate the lumbosacral space. Epidural injection was performed with lidocaine (0.18 mL/kg). Rescue analgesia was not necessary during the caudectomy procedure. The procedure had a total duration of 3 h and extubation occurred 3 min after inhalation anesthesia withdrawal. At the end of the surgery, the animal was medicated with meloxicam (0.1 mg/kg) and methadone (0.2 mg/kg). Two h after the end of the surgery, the animal was able to feed again.Discussion: The literature is scarce regarding anesthetic techniques in the Nasua nasua species, especially in the context of locoregional anesthesia. In this report, the protocol used as pre-anesthetic medication was considered satisfactory. Brachial plexus block is a safe technique for desensitizing the forelimb for surgical procedures distal to the scapulohumeral joint. Despite some morphological differences in the spinal anatomy of coatis, there was no difficulty in identifying the epidural space or inserting the needle. The absence of complications, and the hemodynamic stability during the anesthesia period, combined with the satisfactory recovery of the patient points to the success of the techniques used in the present report.
Background: The Coragyps atratus flies long distances in search of food and has a marked behaviour of food competition. Since they are frequently found in areas of recent human occupation, they are subject to trauma, which may require surgical interventions. Locoregional blocks are used as part of a balanced-anaesthesia protocol and are currently being evaluated in birds, with brachial plexus block being the main technique described in the literature. However, to our knowledge, this is the first description of intravenous regional anaesthesia (Bier's block) in a vulture. Thus, we aim to report the use of Bier's block with 1% lidocaine, in a black-headed vulture submitted to digit amputation. Case: A black-headed vulture (Coragyps atratus), weighing 2 kg, was rescued and referred to the Veterinary Hospital due to its inability to fly. Physical examination revealed a swollen digit in the right pelvic limb. Radiographic examination confirmed the intermediate phalanx fracture of the 4th digit of the right pelvic limb with signs suggestive of advanced osteomyelitis. The animal was referred to surgery for amputation of the affected digit. Before surgery, water and food were withdrawn for 12 h. Pre-anaesthetic medication consisted of 1 mg/kg midazolam and 0.5 mg/kg morphine intramuscularly (IM). Anaesthetic induction was performed through face mask with isoflurane, followed by orotracheal intubation with a 3 mm-endotracheal tube. Anaesthesia was maintained with isoflurane through a non-rebreathing circuit in 100% oxygen. Using a multiparametric monitor, heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and core temperature (CT) were evaluated. Antisepsis of the right pelvic limb was performed and an elastic band was applied around the distal region of the affected tibia to serve as a tourniquet. A scalp vein set was used to access the lateral saphenous vein in the region distal to the tourniquet, and 5 mg/kg lidocaine 1% was injected intravenously. The patient remained stable during the procedure, with no need for analgesic rescue. The tourniquet was gradually released 40 min past its application, being completely removed after 45 min of surgery. The anaesthetic supply was interrupted, with extubation after 4 min; the patient had satisfactory anaesthetic recovery. Discussion: The present report describes the success in using the technique of intravenous regional anaesthesia with 1% lidocaine for digit amputation performed on a specimen of black-headed vulture. The pre-anaesthetic medication provided analgesia, satisfactory sedation for venoclysis, and anaesthetic induction without complications. Anaesthetic induction and maintenance in birds are preferably performed with inhaled anaesthetics, thus the choice of mask induction. Despite the reduction in RR soon after induction, the patient remained on spontaneous ventilation. Bier's block using 5 mg/kg lidocaine showed to be an easy and safe technique in vultures, but doses up to 6 mg/kg lidocaine are not associated with adverse effects in birds. The intravenous regional anaesthesia technique described in this manuscript promoted adequate analgesia for the digit amputation procedure in black-headed vultures and allowed hemodynamic stability without significant anaesthetic complications. Thus, the present report points to the potential use of this locoregional block in other birds. Keywords: locorregional block, lidocaine, anaesthesia. Título: Anestesia regional intravenosa (bloqueio bier) em urubu-de-cabeça-preta (Coragyps atratus) submetido à amputação de dígito. Descritores: bloqueio locorregional, lidocaína, anestesia.
RESUMO Objetivou-se avaliar o bloqueio sensitivo e motor da administração peridural de 0,2mL/kg de duas concentrações de ropivacaína em comparação à lidocaína em cães. Utilizaram-se 24 cães, distribuídos em quatro grupos: NaCl a 0,9% (GS), lidocaína a 2% (GL), ropivacaína a 0,5% (GR5) e ropivacaína a 0,75% (GR7,5). Avaliaram-se a presença de movimentação espontânea, deambulação, sensibilidade superficial e profunda nos momentos cinco, 10, 15, 20, 25, 30, 45, 60, 90, 120, 180, 240 e 300 minutos após peridural. O retorno à movimentação espontânea foi semelhante entre GL (42,50 ± 6,12) e GR7,5 (69,2 ± 58,9). O tempo para deambulação foi mais prolongado em GR7,5 (107,5 ± 79,3) que em GS (9,2 ± 3,8) e em GR5 (32,5 ± 20,9). O retorno da sensibilidade profunda foi maior em GR 7,5 (152,5 ± 89,2) que em GS (5,8 ± 2,0), GR5 (46,7 ± 46,3) e GL (52,5 ± 20,7). O tempo de retorno da sensibilidade superficial foi maior em GR7,5 (205,0 ± 129,3) que em GS (7,5 ± 2,7), GL (72,5 ± 19,9) e GR5 (97,5 ± 55,1). Apesar do retorno precoce da movimentação, ropivacaína 0,75% está relacionada a tempo prolongado de recuperação da função muscular e bloqueio sensitivo mais prolongado que lidocaína e ropivacaína 0,5%.
Background: The anatomical, physiological, and pharmacological characteristics of reptiles make anesthesia in chelonians particularly challenging. Specific literature regarding safe anesthetic protocols that provide immobilization, antinociception, amnesia, and unconsciousness are scarce. Thus, this paper aims to report the case of a red-footed tortoise submitted to long-duration general anesthesia to celiotomy for foreign body removal. Case: An adult red-footed tortoise (Chelonoides carbonaria), 5.9 kg, was admitted due to hyporexia after ingesting a metallic fishhook. Serial radiographs confirmed the diagnosis and location of the foreign body in the stomach. The animal was premedicated with 0.03 mg/kg dexmedetomidine, 6 mg/kg ketamine, and 0.4 mg/kg butorphanol intramuscularly. After 90 min we inserted a 22G jugular catheter and proceeded to anesthesia induction with 5 mg/kg propofol. We intubated the animal with a 2.5 mm uncuffed endotracheal and started fluid therapy at a rate of 5 mL/kg/h. Surgical anesthesia was maintained with isoflurane in 0.21 oxygen, in a non-rebreathing circuit (baraka), under spontaneous breathing. Expired isoflurane was maintained between 3 and 4.5%. Due to reduced respiratory rate and hypercapnia, we opted for implementing manually-assisted positive pressure ventilation. Morphine (0.5 mg/kg) was administered at 10 and 87 min after the beginning of the surgery for further analgesia when the isoflurane requirement increased significantly. We did not detect any alterations in heart and body temperature. Surgical anesthesia lasted 6 h. During anesthesia recovery, voluntary head retraction and coordinated movement of the limbs occurred at 240 and 540 min after the extubation, respectively. In 2 days, the patient returned to voluntary feeding, being very active and responsive to stimulus. The post-surgical hematologic evaluation was unremarkable. Discussion: Pre-anesthetic medication aimed to promote sedation and preemptive analgesia. Due to its minimal cardiorespiratory depression, we chose the combination of ketamine, dexmedetomidine, and butorphanol. Dexmedetomidine reduced the ketamine dose and caused sufficient muscle relaxation and immobilization to perform the jugular catheter placement. Butorphanol is an agonist-antagonist opioid; that is why we decided to add it to the protocol for antinociception. However, due to signs of nociceptive response (increased isoflurane requirements and heart rate), and considering the evidence of a predominance of μ receptors in reptiles, we administered low-dose morphine twice during the procedure. Propofol was chosen as an induction agent at a dose sufficient to allow endotracheal intubation. Since reptilians often show apnea in the presence of 100% oxygen, we used a 0.21 oxygen fraction. Despite this, the patient showed respiratory depression. Due to right to left cardiac shunt, sudden changes in the direction of the blood can lead to very rapid changes in the serum concentrations of isoflurane, which leads to frequent oscillations in the anesthetic depth and consequently the need for vaporizer adjustments, which may justify the high expired isoflurane fraction during the procedure. Despite that, physiological parameters were maintained within normal ranges for the species, with slight variations during the surgical procedure. We conclude that the proposed anesthetic protocol is safe for long-duration anesthesia in chelonians, ensuring cardiovascular and respiratory stability. Thus, this report may help veterinarians to perform safe anesthesia in tortoises submitted to invasive surgical procedures. Keywords: testudines, dexmedetomidine, ketamine, butorphanol. Descritores: testudines, dexmedetomidina, cetamina, butorfanol.
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