Uso de agentes analgésicos en el periodo transquirúrgico
Fecha
2008
Autores
Pérez Anchía, Sharon Naomi
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad Nacional, Costa Rica
Resumen
Durante los meses de julio a octubre del 2007 se realizó una pasantía en el Colegio
Veterinario Ontario, en la Universidad de Guelph, Ontario, Canadá. En este periodo se
observaron alrededor de 150 casos, de los cuales 71 fueron pacientes sometidos a
procedimientos quirúrgicos y se incluyen como casuística.
De los 71 casos observados, 16 fueron equinos, 48 caninos incluyendo una hiena, 6
felinos y 1 suino. Sesenta y ocho de los pacientes recibieron anestesia inhalatoria con
isofluorano, los otros 3 no fueron sometidos a anestesia general.
Las cirugías de tipo ortopédico fueron las que predominaron (31 casos) y en segundo
lugar las de abordaje abdominal (15 casos). De todos los fármacos con acción analgésica
utilizados en el proceso transquirúrgico, la hidromorfona, el fentanyl en infusión, la lidocaína
en infusión, el meloxicam al finalizar la cirugía y la morfina epidural fueron los que más se
administraron en especies menores, mientras que para equinos la medetomidina en infusión,
lidocaína en bolos y la ketamina durante la inducción fueron los más utilizados.
En un 73% de los casos fue necesaria la utilización de un ventilador artificial, entre
estos se encuentran el 100% de los equinos que recibieron anestesia inhalatoria.
Como drogas de emergencia se utilizó en la mayoría de los casos de especies menores
la dopamina, la dobutamina en especies mayores y el glicopirrolato principalmente en caninos.
Ketamina/diazepam fue la combinación de drogas predilecta para inducir la anestesia
tanto en especies menores como mayores.
Los porcentajes en que se mantuvo el isofluorano en el OVC son similares a los
utilizados en nuestro medio (1,5% en promedio), a pesar de que por el uso de agentes
analgésicos los requerimientos de este gas en pacientes sometidos a cirugía debieron de ser
menores, por la reducción en el MAC de anestésicos inhalatorios que se obtiene con la
administración de este tipo de drogas.
Between July and October, 2007, an externship at the Ontario Veterinary College, University of Guelph, Ontario, Canada, was performed. Seventy one of the 150 cases observed in this period at the Anesthesiology Department were submitted to surgical procedures and are included as casuistic. Of the 71 cases, 16 were equines, 47 dogs and 1 hyena, 6 cats and 1 suine. Sixty eight of the patients received inhalant anesthesia with isofluorane. The orthopedic surgeries were the most realized during the three months (31 cases) and in second place those of abdominal approach (15 cases). Of all the analgesic drugs used during the surgeries, the hydromorphone, fentanyl infusion, lidocaine infusion, meloxicam at the end of the surgery and epidurals with morphine were administered in the majority of the small animal patients, while for equines the medetomidine infusion, lidocaine shots and ketamine during the induction period were the most utilized. In 73% of the cases the use of an artificial ventilator was necessary, all the equines under general anesthesia with isofluorane received artificial breathing. Dopamine in small animals, dobutamine in horses and glycopirrolate mostly in dogs were the preferred emergency drugs. The combination ketamine/diazepam was the favorite to induce the anesthesia in both small and large animals. The amount of isofluorane used in the OVC and in our country to maintained anesthesia is the same (a mean of 1.5%). Although the request of this gas by using analgesics should be significantly less because the reduction effect of this drugs over the isofluorane MAC.
Between July and October, 2007, an externship at the Ontario Veterinary College, University of Guelph, Ontario, Canada, was performed. Seventy one of the 150 cases observed in this period at the Anesthesiology Department were submitted to surgical procedures and are included as casuistic. Of the 71 cases, 16 were equines, 47 dogs and 1 hyena, 6 cats and 1 suine. Sixty eight of the patients received inhalant anesthesia with isofluorane. The orthopedic surgeries were the most realized during the three months (31 cases) and in second place those of abdominal approach (15 cases). Of all the analgesic drugs used during the surgeries, the hydromorphone, fentanyl infusion, lidocaine infusion, meloxicam at the end of the surgery and epidurals with morphine were administered in the majority of the small animal patients, while for equines the medetomidine infusion, lidocaine shots and ketamine during the induction period were the most utilized. In 73% of the cases the use of an artificial ventilator was necessary, all the equines under general anesthesia with isofluorane received artificial breathing. Dopamine in small animals, dobutamine in horses and glycopirrolate mostly in dogs were the preferred emergency drugs. The combination ketamine/diazepam was the favorite to induce the anesthesia in both small and large animals. The amount of isofluorane used in the OVC and in our country to maintained anesthesia is the same (a mean of 1.5%). Although the request of this gas by using analgesics should be significantly less because the reduction effect of this drugs over the isofluorane MAC.
Descripción
Modalidad: Pasantía
Palabras clave
CIRUGÍA VETERINARIA, VETERINARY SURGERY, ANALGESICOS, FARMACOLOGIA VETERINARIA, VETERINARY FARMACOLOGY