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Master's Dissertation
DOI
https://doi.org/10.11606/D.74.2020.tde-05052021-151758
Document
Author
Full name
Mariana Cardoso Sanches
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Pirassununga, 2020
Supervisor
Committee
Carregaro, Adriano Bonfim (President)
Beier, Suzane Lilian
Cortopassi, Silvia Renata Gaido
Dellova, Deise Carla Almeida Leite
Title in Portuguese
Dexmedetomidina como adjuvante na anestesia intravenosa total com propofol em gatas submetidas à ovariohisterectomia
Keywords in Portuguese
Agonista α2 adrenérgico
Analgesia
Anestesia
Gatos
Sedação
Abstract in Portuguese
O uso de adjuvantes na anestesia total intravenosa (AIT) possibilita a redução da dose de propofol para manutenção anestésica, reduzindo assim seus efeitos indesejáveis, além da possibilidade de promover analgesia. O presente estudo objetivou avaliar a dexmedetomidina, em diferentes taxas de infusão, como adjuvante na AIT com propofol em gatas. Foram utilizadas 28 gatas hígidas alocadas em quatro grupos: Prop, Dex1, Dex3 e Dex5. Os animais de Dex1, Dex3 e Dex5 receberam como medicação pré-anestésica (MPA) 5 µg/kg de dexmedetomidina, via intramuscular e os animais de Prop, receberam 0,1 mL de NaCl 0,9%. A indução anestésica de todos os grupos foi realizada por meio da administração, dose-efeito, de propofol (1 mg/kg a cada 10 segundos). Para a manutenção anestésica o grupo Prop recebeu 0,3 mg/kg/min de propofol e 3 mL/kg/hora de NaCl 0,9%; os grupos Dex1, Dex3 e Dex5 receberam 0,2 mg/kg/minuto de propofol e respectivamente 1 µg/kg/hora, 3 µg/kg/hora e 5 µg/kg/hora de dexmedetomidina, diluída em NaCl 0,9% (3 mL/kg/hora). Os animais foram mantidos em anestesia por 100 minutos, sendo que os primeiros 60 minutos foram utilizados para ajustar as doses necessárias para manutenção anestésica e após, as gatas foram submetidas à ovariohisterectomia, padronizada em 40 minutos. Durante o período transanestésico os parâmetros cardiorrespiratórios, plano anestésico, doses necessárias para a realização da manutenção anestésica e necessidade de suplementação analgésica foram avaliados em intervalos de 10 minutos, enquanto que os gases sanguíneos e eletrólitos foram avaliados aos 5 e 60 minutos após a indução. No período pós-operatório foram avaliados o tempo e qualidade de recuperação anestésica, escore de sedação e analgesia. As adições de dexmedetomidina, nas doses de 1, 3 e 5 µg/kg/hora, reduziram o consumo de propofol em 72,8%, 71,1% e 74,6% respectivamente. O uso concomitante da dexmedetomidina promoveu bradicardia e maiores valores de pressão arterial média quando comparado ao uso isolado de propofol. O grupo Prop apresentou mais eventos classificados como hipotensão que os demais grupos. A quantidade de suplementação analgésica transoperatória dos grupos Dex1, Dex3 e Dex5 foi consideravelmente menor do que do grupo Prop (Dex1 3 [2;4], Dex3 3 [2;4], Dex5 3 [2;4] e Prop 5 [4;7]). O tempo de recuperação anestésica foi menor nos grupos Dex1 (129 minutos [122;134]) e Dex3 (127 minutos [70;139]), quando comparados aos grupos Dex5 (130 minutos [88;155]) e Prop (165 minutos [135;180]). O Prop apresentou pior escore de recuperação anestésica quando comparado aos grupos Dex1 e Dex5 (Dex1 4 [4;5], Dex3 3 [3;4], Dex5 4 [3;5] e Prop 1 [1;3]). Conclui-se que a adição de dexmedetomidina na AIT reduz a necessidade de propofol para a manutenção anestésica e promove certo grau de analgesia transoperatória, reduz o tempo de recuperação anestésica e melhora a qualidade desta. A dose de 1 µg/kg/hora de dexmedetomidina apresentou menores alterações nos valores da pressão arterial média, sendo considerada a melhor opção para animais normo e hipertensos.
Title in English
Dexmedetomidine as an adjuvant in total intravenous anesthesia with propofol in cats submitted to ovariohysterectomy
Keywords in English
α2 adrenergic agonist
Analgesia
Anesthesia
Cats
Sedation
Abstract in English
The use of adjuvants agents in total intravenous anesthesia (TIVA) reduces the rate of propofol required for anesthetic maintenance, thus reducing its undesirable side effects, besides the possibility of promoting analgesia. The present study aimed to evaluate dexmedetomidine in different infusions rates as an adjuvant to TIVA with propofol, in cats. Twenty-eight heathy cats were divided into four groups: Prop, Dex1, Dex3 and Dex5. The animals from Dex1, Dex3 and Dex5 received 5 µg/kg of dexmedetomidine as premedication and the from the Prop group received 0.1 mL of NaCl 0,9%. Induction in all groups was achieved through the dose-effect administration of propofol (1 mg/kg every 10 seconds). For anesthetic maintenance, the Prop group received 0.3 mg/kg/minute of propofol and 3 mL/kg/hour of NaCl 0.9%; the groups Dex1, Dex3 and Dex5 received 0.2 mg/kg/minute of propofol and 1 µg/kg/hour, 3 µg/kg/hour and 5 µg/kg/hour of dexmedetomidine, respectively, diluted in NaCl 0.9% (3 mL/kg/hour). The animals were kept under anesthesia for 100 minutes, being the first 60 minutes used for the adjustment of the infusion rates required for anesthetic maintenance. Afterwards, the cats were submitted to ovariohysterectomy, the duration of the surgery standardized to 40 minutes. During the anaesthesia, cardiorespiratory parameters, drug rates and the need for rescue analgesia were evaluated at 10-minute intervals, while blood gases and electrolytes were assessed at 5 and 60 minutes after induction. In the postoperative period, the length and quality of anesthetic recovery, sedation scores and analgesia were evaluated. The addition of dexmedetomidine at the doses of 1, 3 and 5 µg/kg/hour reduced propofol consumption by 72.8%, 71.1% and 74.6% respectively. The concomitant use of dexmedetomidine promoted bradycardia and an increase in the mean arterial pressure values when compared to propofol alone. The Prop group had more events classified as hypotension than the other groups. Rescue analgesia in the Dex1, Dex3 and Dex5 groups was considerably less frequent than in the Prop group (Dex1 3 [2;4], Dex3 3 [2;4], Dex5 3 [2;4] and Prop 5 [4;7]). The recovery length was shorter in the Dex1 (129 minutes [122;134]) and Dex3 (127 minutes [70;139]) groups when compared to the Dex5 (130 minutes [88;155]) and Prop (165 minutes [135;180]) groups. The Prop group had the worst anesthetic recovery score when compared to the Dex1 and Dex5 groups (Dex1 4 [4;5], Dex3 3 [3;4], Dex5 4 [3;5] and Prop 1 [1;3]). It is possible to conclude that the addition of dexmedetomidine in TIVA reduces the need for propofol during anesthetic maintenance and promotes transoperative analgesia, reduces the time of anesthetic recovery and improves its quality. The dose of 1 µg/kg/hour of dexmedetomidine had less impact over the mean arterial pressure values, being considered the best option for both healthy and hypertensive animals.
 
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Publishing Date
2021-05-05
 
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