Evaluation of the isoflurane-sparing effects of lidocaine and fentanyl during surgery in dogs

Steagall, Paulo V.; Neto, Francisco José Teixeira; Minto, B. W.; Campagnol, Daniela; Correa, M. A.

doi:10.2460/javma.229.4.522

Cited by 69 publications

(79 citation statements)

References 20 publications

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“…Several agents used in CRI can trigger hypotension, such as fentanyl and morphine (LAMONT;MATHEWS, 2007). However, previous studies observed that fentanyl CRI causes an increase in arterial blood pressure, possibly due to the significant reduction in inhalant requirements, or no change in this parameter, probably because fentanyl-induced bradycardia negates the expected improvement in blood pressure (STEAGALL et al, 2006;UEYAMA et al, 2009). Another study showed that, although morphine CRI induced relatively high histamine release even at low doses, this is not associated with adverse physiological effects such as hypotension in healthy dogs (GUEDES; RUDÉ; RIDER, 2006).…”

Section: Discussionmentioning

confidence: 99%

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Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs

et al. 2013

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Constant rate infusion (CRI) shows several advantages in balanced anesthesia, such as reduction of requirement for inhaled anesthetics and control of pain. The most commonly used drugs in these protocols are local anesthetics, dissociative, and opioids, which may be administered alone or in combinations. We evaluated the records of 200 dogs that underwent various surgical procedures with anesthetic or analgesic CRI in the perioperative period during 2011 and 2012 at the Veterinary Hospital of Franca University (Unifran), and identified possible complications during the transoperative period. Records evaluated included clinical state, laboratory tests, drugs used in premedication and induction, and CRI protocol. Acepromazine and morphine were the main drugs used in premedication. Propofol was used to induce anesthesia alone or in combination with other agents. We evaluated records of the 25 different CRI protocols. Fentanyl was the main drug employed in CRI, either alone or in combination. There were 128 episodes of anesthetic complications during CRI;the most common were hypotension, hypertension, and tachycardia, which occurred in 43 (32%), 35 (26.3%), and 19 (14.2%) dogs, respectively. Cardiac arrhythmia was reported in only 4 dogs. Signs of respiratory depression were present in dogs treated with 6 different CRI protocols. The consumption of isoflurane (vol %) reduced between 15.7% and 21.05% after 30minutes of the CRI in the fentanyl and fentanyl-lidocaine-ketamine CRI groups (p<0.05). In conclusion, CRI is a valid component of balanced anesthesia in dogs, safe, and has a low incidence of adverse effects. However, future studies are warranted to describe the results of the clinical use of CRI to better characterize and refine this technique. Key words: Continuous intravenous infusion, fentanyl, ketamine, lidocaine, morphine ResumoO uso de técnicas de infusão contínua (IC) possui inúmeras vantagens na anestesia balanceada, como a redução do requerimento de anestésicos inalatórios e controle da dor. Os fármacos mais comumente utilizados nestes protocolos são os anestésicos locais, dissociativos e opioides, que podem ser administrados isoladamente ou em associações. Foram avaliados os prontuários de 200 cães que foram submetidos a diversos procedimentos cirúrgicos com IC de anestésicos ou analgésicos no período perioperatório durante 2011 e 2012 no Hospital Veterinário da Universidade de Franca (Unifran). Foram identificadas possíveis complicações durante o período trans-operatório. Os registros avaliados incluíram estado clínico, exames laboratoriais, fármacos utilizados na pré-medicação e indução, e protocolos de IC. Acepromazina e morfina foram os principais fármacos usados na pré-medicação. O propofol foi utilizado para induzir a anestesia, isolado ou em associação com outros agentes. Foram avaliados os registros de 25 protocolos diferentes de IC. O fentanil foi o principal fármaco utilizado na IC, isoladamente ou em associação. Houve 128 episódios de complicações anestésicas durante a IC; os mais ...

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Section: Discussionmentioning

confidence: 99%

“…Previous authors reported reduction in heart rate with use of morphine (LUCAS et al, 2001;WIESE;MARCH, 2003) and fentanyl (STEAGALL et al, 2006;BUFALARI et al, 2007;UEYAMA et al, 2009) CRIs. Steagall et al (2006) showed that hypertension spikes were avoided by fentanyl CRI administration in dogs, compared with a control group.…”

Section: Discussionmentioning

confidence: 99%

Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs

et al. 2013

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“…For protocols of balanced anesthesia, opioid analgesic infusions are commonly used in combination with inhalation anesthetics, as opioid analgesic infusions reduce the MAC of inhalation anesthetics (STEAGALL et al, 2006;MONTEIRO et al, 2010) and reduce the rate of infusion of intravenous anesthetics (CARARETO et al, 2004). Remifentanil has a pharmacokinetic profile that is ideal for continuous infusion with rapid onset of action and elimination, and its elimination is independent of hepatic and renal function (HOKE et al, 1997;EGAN, 2000).…”

Section: Discussionmentioning

confidence: 99%

Avaliação da concentração expirada de isoflurano em infusão continua de remifentanil em cadelas submetidas a mastectomia

et al. 2015

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The aims of this study were to evaluate the effects of two constant rate infusions of remifentanil on end tidal isoflurane (ETiso) in dogs undergoing mastectomy surgery. Eighteen bitches, 12+2 years of age, weighing 15+5 Kg were randomized into 3 groups (n=6/group) and underwent unilateral mastectomy due to mammary neoplasia. All animals received the premedications of morphine (0.5 mg Kg -1 ) and acepromazine (0.03 mg Kg -1 ) by intramuscular route (IM). Propofol dose-effect was used for induction of anesthesia. The animals were intubated and connected to a circle breathing system, and IPPV (intermittent positive pressure ventilation) was used to maintain normocapnia with an oxygen flow rate of 2 L/min and FiO 2 100%. Anesthesia was maintained with isoflurane and saline solution (control group [GCON], n=6) or intravenous infusion of remifentanil at a rate of 0.15 µg Kg -1 min -1 (REMI 0.15 n=6) or 0.3 µg Kg -1 min -1 (REMI 0.3 n=6). Cardiopulmonary variables and ETiso were monitored before and every 15 minutes after the start of surgery. The data were analyzed by ANOVA with multiple repetitions between moments and ANOVA followed by the Student Newman Keuls test (≤0.05) for comparisons between groups. Heart rate was lower at all moments in the REMI 0.15 and REMI 0.3 groups than in the GCON, and heart rate was not significantly different between the two remifentanil infusion groups. Additionally, the arterial blood pressure values (SAP, MAP and DAP) were not different between all groups. Baseline values (before surgery) of ETiso were not different between the 3 groups. After the start of surgery, ETiso ranged from 1.37±0.3 to 1.05±0.19 in the control group; in the REMI 0.15 and REMI 0.3 groups, ETiso was 36.5% and 65.7% lower than in the control group (M15). Remifentanil infusion reduced ETiso in a dose-dependent manner in animals undergoing radical mastectomy without causing significant cardiopulmonary alterations. Key words: Dogs, mastectomy, remifentanil, isoflurane ResumoOs objetivos deste estudo são a avaliação dos efeitos de duas taxas fixas de infusão continua de remifentanil na concentração expirada de isoflurano (ETiso) em cadelas submetidas à mastectomia. aleatoriamente em 3 grupos (n=6/grupo) e submetidos à mastectomia unilateral devido a neoplasia mamária. Todos os animais foram pré-medicados com morfina (0,5 mg Kg -1 ) e acepromazina (0,03 mg Kg -1 ), ambas por via intramuscular (IM). A indução da anestesia foi realizada com propofol (doseefeito). Os animais foram intubados e conectados a um sistema circular com reinalação de gases. Foi utilizada ventilação com pressão positiva intermitente para manutenção de normocapnia com fluxo de oxigênio de 2 L/min e FiO 2 de 100%. A anestesia foi mantida com isoflurano e solução salina (grupo controle [GCON], n=6) ou infusão intravenosa de remifentanil na taxa de 0,15 µg Kg -1 min -1 (REMI 0,15 n=6) ou 0,3 µg Kg -1 min -1 (REMI 0,3 n=6). As variáveis cardiovasculares e a ETiso foram monitoradas antes e a cada 15 minutos após o início da cirurgia. Os dado...

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“…Ademais, histologicamente, cerca de 50% dos tumores mamários em cadelas são malignos (Queiroga e Lopes, 2002;Stratmann, 2008), sendo a sua maioria representada pelos carcinomas (Daleck et al, 1998).…”

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Anestesia convencional e técnica de tumescência em cadelas submetidas à mastectomia. Avaliação da dor pós-operatória

Aguirre

Minto

Faria

et al. 2014

Arq. Bras. Med. Vet. Zootec.

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RESUMOAs neoplasias mamárias são as mais comuns em cadelas e geralmente acometem fêmeas de meia-idade a idosas, não castradas ou que foram submetidas ao procedimento de ovario-histerectomia tardiamente. A principal forma de tratamento é a excisão cirúrgica, sendo a ressecção unilateral das glândulas mamárias o procedimento mais realizado na prática veterinária. O objetivo do presente estudo foi comparar a dor pós-operatória em cadelas submetidas ao procedimento de mastectomia unilateral sob efeito das técnicas anestésicas de tumescência ou convencional. Foram utilizadas 20 cadelas, divididas em dois grupos: um grupo recebeu apenas a anestesia geral inalatória (grupo convencional), e o outro recebeu adicionalmente a anestesia infiltrativa por tumescência (grupo tumescência). Elas foram avaliadas nas primeiras 24 horas do período pós-operatório, e o processo álgico foi avaliado pela escala de dor da Universidade de Melbourne. As médias dos escores obtidos ao longo do tempo foram submetidas ao teste de Tukey a um nível de 5% de significância (p<0,05). Não foram observadas diferenças significativas entre os grupos com relação à dor pós-operatória. A técnica anestésica infiltrativa por tumescência apresentou a vantagem da redução do sangramento transoperatório e mostrou-se exequível em pequenos animais, entretanto seu uso está relacionado à experiência e à preferência do cirurgião e do anestesista.

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Evaluation of the isoflurane-sparing effects of lidocaine and fentanyl during surgery in dogs

Abstract: Administration of fentanyl resulted in greater isoflurane sparing effect than did lidocaine. However, it appeared that the low heart rate induced by fentanyl may partially offset the improvement in mean arterial pressure that would be expected with reduced isoflurane requirements.

Cited by 69 publications

References 20 publications

Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs

Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs

Avaliação da concentração expirada de isoflurano em infusão continua de remifentanil em cadelas submetidas a mastectomia

Anestesia convencional e técnica de tumescência em cadelas submetidas à mastectomia. Avaliação da dor pós-operatória

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