Caracterización de arritmias cardíacas tras el uso de infusiones analgésicas continuas de tramadol o lidocaína en perras ovariohisterectomizadas

Edwin Fernando Buritica Gaviria, Diego Fernando Echeverry Bonilla, Mario Fernando Arévalo Carbonell, Ana Maria Alvarado Poveda, Diego Alejandro Ospina Argüelles

Resumen


Las infusiones analgésicas continuas (IAC) son estrategias eficaces para controlar el dolor agudo post-quirúrgico; sin embargo, dependiendo del fármaco empleado, la electrofisiología cardiaca puede alterarse y evidenciar taquiarritmias, bradiarritmias, complejos ventriculares, fibrilación y bloqueos atrioventriculares. El objetivo de este estudio fue caracterizar las anormalidades electrocardiográficas observadas luego de implementar el uso de infusiones analgésicas continuas de tramadol o lidocaína en perras post-ovariohisterectomizadas. Se emplearon 26 pacientes (26,6 ± 17,6 meses; 15,34 ± 7,81 kg) divididos en tres grupos: Grupo 1 tramadol (n= 9); Grupo 2 lidocaína (n=10) y Grupo 3 NaCl 0,9% como control (n= 7). Las variables estudiadas fueron frecuencia cardiaca media, máxima y mínima en latidos por minuto (lpm), morfología de los complejos anómalos y escala de Glasgow modificado. La frecuencia cardiaca media, máxima y mínima correspondiente a cada grupo fue: Tramadol 90, 253 y 43 lpm respectivamente; lidocaína 93, 238 y 42 lpm respectivamente; control 100, 253 y 40 lpm respectivamente. El grupo control evidenció el mayor número de eventos arrítmicos, siendo la anomalía más frecuente los complejos supraventriculares prematuros. Se concluyó que las IAC de tramadol o lidocaína a las dosis empleadas en el presente estudio no generan alteraciones electrocardiográficas de impacto clínico; siendo el protocolo lidocaína el que evidenció el menor número de arritmias y el mejor comportamiento de la frecuencia cardiaca.

Characterization of cardiac arrhythmias following the use of continuous infusions analgesic of tramadol or lidocaine in dogs ovariohysterectomised

The use of continuous analgesic infusions (IACs) is an effective strategy for the control of postoperative pain in canines; however, depending on the used drug, cardiac electrophysiology can be altered by the presence of tachyarrhythmias, bradyarrhythmias, ventricular complexes, fibrillation or atrioventricular block. The aim of this study was to evaluate the heart rate and to characterize the electrocardiographic abnormalities during the use of continuous postoperative analgesic infusions of tramadol or lidocaine in ovariohysterectomized bitches using 24-hour Holter monitoring. For this purpose, 26 healthy canine females (26.6 ± 17.6 months, 15.34 ± 7.81 kg) were divided into three groups: Group 1 NaCl 0.9% as control (n = 7), Group 2 lidocaine 100μg / kg / minute (n = 10) and Group 3 tramadol 22μg / kg / minute (n = 9). As results the mean, minimum and maximum heart rate found in each group were Control 100, 40 and 253 bpm. Lidocaine 93, 42 and 238 bpm and Tramadol 90, 43 and 253 bpm; on the other hand, a total of 20/26 (76.9%) of the studied animals presented several electrocardiographic alterations that included in their order SVPC, AVB, VPC and RR pauses, however, there were no statistically significant differences (p<0.05) between the evaluated groups. It is concluded that the IACs of tramadol or lidocaine under the described experimental conditions do not generate statistically significant electrocardiographic alterations, but could play a role in the minimization of those parameters when used in a complementary way during the postoperative period.

Keywords: analgesia, electrocardiography, Holter.

Caracterização de arritmias cardíacas após o uso de infusões analgésicas contínuas de tramadol ou lidocaína no pós-operatório de cadelas ovário histerectomizadas

O uso de infusões contínuas de analgésicos (ICA) é uma estratégia eficaz para o controle da dor pós-operatória em cães. No entanto, dependendo do fármaco utilizado, a eletrofisiologia cardíaca pode ser alterada observando-se a presença de taquiarritmias, bradiarritmias, complexos ventriculares, fibrilação ou bloqueios atrioventriculares. O objetivo deste estudo foi avaliar a frequência cardíaca e caracterizar as anomalias eletrocardiográficas, utilizando-se Holter 24 horas, observadas durante o uso de infusões analgésicas contínuas de Tramadol ou Lidocaína no pós-operatório de cadelas ovário histerectomizadas. Para isso, foram utilizadas 26 cadelas saudáveis (26,6 ± 17,6 meses; 15,34 ± 7,81 kg) divididas em três grupos: Grupo 1 NaCl 0,9% como controle (n=7), Grupo 2 lidocaína 100 µg/kg/minuto (n=10) e Grupo 3 Tramadol 22 µg/kg/minuto (n=9). Não foram evidenciadas diferenças estatisticamente significativas (p< 0,05) entre os grupos avaliados. A frequência cardíaca média, mínima e máxima encontradas em cada grupo foram: Controle 100, 40 e 238 bpm, Lidocaína 93, 42 e 238 bpm, e Tramadol 90, 43 e 253 bpm. Por outro lado, um total de 20/26 (76,9%) dos animais estudados apresentaram diversas alterações eletrocardiográficas incluindo, em ordem do mais para o menos frequente, CSVP, BAV, CVP e pausas RR. Concluiu-se que as ICA de tramadol ou lidocaína, nas condições do presente estudo, não produziram alterações eletrocardiográficas estatisticamente significativas, mas poderiam minimizar as mesmas se fossem utilizadas de forma complementar durante o período pós-operatório.

Palavras-chave: analgesia, eletrocardiografia, Holter.

http://dx.doi.org/10.21615/cesmvz.12.1.1


Palabras clave


analgesia, electrocardiografía, Holter.

Citas


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