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Master's Dissertation
DOI
10.11606/D.10.2016.tde-09092016-152602
Document
Author
Full name
Paula Finkensieper Pacheco
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2013
Supervisor
Committee
Cortopassi, Silvia Renata Gaido (President)
Safatle, Angélica de Mendonça Vaz
Silva, Ricardo Duarte
Title in Portuguese
Considerações anestésicas no paciente diabético: avaliação dos distúrbios do equilíbrio ácido-base em cães submetidos à facoemulsificação
Keywords in Portuguese
Anestesia
Cães
Desequilíbrio ácido-base
Diabetes mellitus
Abstract in Portuguese
A diabetes mellitus é uma das endocrinopatias mais frequente em cães e sabe-se que esses pacientes são mais propensos a desenvolver complicações anestésicas quando comparados aos não-diabéticos. Desta forma, objetivou-se avaliar, durante o período perioperatório, as possíveis alterações no equilíbrio ácido-base e complicações anestésicas em cães diabéticos submetidos a facoemulsificação. Foram incluídos 30 cães, sendo 15 diabéticos e 15 não portadores da afecção. Foram determinados o pH, bicarbonato e déficit de base, além de eletrólitos plasmáticos (sódio, cloro, potássio). Adicionalmente, foram avaliadas as variáveis cardiorrespiratórias no período trans-anestésico. Com relação aos distúrbios ácido-base, os pacientes não apresentaram alterações compatíveis com acidose metabólica, apenas discreta acidemia após 30 minutos de anestesia. Apesar dos pacientes diabéticos apresentarem valores de bicarbonato inferiores ao grupo controle, estes permaneceram dentro dos valores de referência. A distribuição dos valores de eletrólitos foi diferente entre os grupos, exceto os valores de cloro. Nos pacientes diabéticos, a hiponatremia ocorreu em seis animais ao término do procedimento cirúrgico e 73% dos cães apresentaram hipercalemia após a administração da medicação pré-anestésica. A complicação anestésica mais comum foi a hipotensão arterial, sendo que 80% dos animais diabéticos apresentaram pressão arterial média inferior a 60 mmHg após indução anestésica. Concluindo, houve variação discreta do equilíbrio ácido-base nos cães diabéticos. Tendo em vista que a acidemia foi verificada em ambos os grupos, sugere-se que a mesma esteja relacionada ao procedimento anestésico. Os pacientes diabéticos submetidos à anestesia geral são mais propensos à hipotensão arterial, sendo que essa alteração merece maiores investigações
Title in English
Anesthetic considerations in the diabetic patient: evaluation of disorders of acid-base balance in dogs undergoing phacoemulsification
Keywords in English
Acid-base imbalance
Anaesthesia
Diabetes Mellitus
Dogs
Abstract in English
Diabetes mellitus is one of the most common endocrinopathies in dogs and it is know that these patients are more likely to develop anesthetic complications when compared to non-diabetics. Thus, this study aimed to evaluate potential changes in acid-base balance and anesthetic complications in diabetic dogs undergoing phacoemulsification during the perioperative period. Thirty dogs were included, fifteen diabetic and fifteen non-carriers of the disease and were analyzed for pH, bicarbonate, blood gas and plasma electrolytes (sodium, chloride, potassium). Additionally, we evaluate the cardiorespiratory variables in the peri-anesthetic period. With respect to acid-base disturbances, patients showed no changes consistent with metabolic acidosis, but a mild acidemia after 30 minutes of anesthesia. Although diabetic patients showed values of bicarbonate below the control group, these were within the reference values. The distribution of the electrolyte was different between groups, except for the amounts of chlorine. In diabetic patients, hyponatremia occurred in six animals at the end of the surgical procedure and 73% of dogs showed hyperkalemia after administration of premedication. The most common anesthetic complication was hypotension, and 80% of diabetic animals showed mean arterial pressure below 60 mmHg after induction of anesthesia. In conclusion, there was a slight variation of the acid-base balance in diabetic dog. Given that acidemia was observed in both groups, it is suggested that it is related to the anesthetic procedure. Diabetic patients undergoing general anesthesia are more prone to hypotension, and this change deserves further investigation
 
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Publishing Date
2016-09-23
 
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