Efectos cardiopulmonares y ácido-base de la infusión continua de fentanilo, ketamina y lidocaína en pacientes caninos ASA I

Luis Adolfo Vergara Saldarriaga, Sandra Patricia Acevedo Toro, Sonia Cecilia Orozco Padilla, Luis Fernando Restrepo Betancur

Resumen


La combinación de fentanilo, lidocaína y ketamina (FLK) se ha utilizado ampliamente en la cirugía canina como parte del protocolo analgésico. Algunos efectos asociados con su aplicación han sido descritos por la literatura. El objetivo del presente trabajo fue evaluar los efectos cardiopulmonares producidos por la infusión de FLK y el uso de isoflurano durante la cirugía en pacientes caninos ASA I. Las muestras fueron tomadas de nueve hembras caninas de diferentes razas, edades y tamaños que se presentaron para la ovariohisterectomía y recibieron una infusión continua de FLK (0,08, 30 y 15 μg/kg/min, respectivamente) como parte del protocolo analgésico. Antes (tiempo 1; T1) y durante (tiempo 2; T2) la cirugía se tomaron medidas de frecuencias cardíaca y respiratoria, presión arterial no invasiva, índice y gasto cardíaco, saturación arterial de oxígeno, dióxido de carbono espirado, temperatura, presión parcial arterial de dióxido de carbono y oxígeno, bicarbonato, pH sanguíneo, dióxido de carbono total y lactato sanguíneo. Los resultados de la temperatura corporal y el pH en T1 y T2 fueron estadísticamente diferentes (p<0,05). Se concluye que no hubo diferencia entre los efectos de las variables cardiorrespiratorias y hemodinámicas en T1 y T2. Los resultados encontrados indican que los cambios en el pH y la temperatura se dieron por factores adicionales a la infusión FLK. Aunque las variables cardiovasculares y hemodinámicas no se encontraron como significativas, fue posible observar una mejora en la perfusión tisular y la estabilidad hemodinámica.

 

Cardiopulmonary and acid-base effects of continuous infusion of fentanyl, ketamine and lidocaine in canines ASA I

The combination of fentanyl, lidocaine, and ketamine (FLK) has been widely used in canine surgery as part of the analgesic protocol. Some effects associated with its application have been described by the literature. The objective was to evaluate the cardiopulmonary effects produced by the infusion of FLK and the use of isoflurane during surgery in canine ASA I patients. Samples was taken of nine healthy female dogs of different breeds, ages, and sizes undergoing ovariohysterectomy that received a continuous infusion of FLK (0,08, 30, and 15 μg/kg/min, respectively) as part of the analgesic protocol. The results of cardiac and respiratory rates, non-invasive blood pressure monitoring, cardiac output and index, arterial oxygen saturation, end-tidal carbon dioxide, body temperature, arterial partial pressure of carbon dioxide and oxygen, bicarbonate, blood pH, total carbon dioxide, and blood lactate were measured before (time 1; T1) and during (time 2; T2) the surgery. Body temperature and acid base status at T1 and T2 were statistically different (p<0,05). In contrast, there was no difference between the effects of the analgesic protocol on cardiorespiratory and hemodynamic variables at T1 and T2. The results found indicate that changes in pH and temperature were due to additional factors different conditions outside the FLK infusion. Although cardiovascular and hemodynamic variables were not found as significant, it was possible to observe an improving on tissue perfusion and hemodynamic stability. 

Keywords: anesthesia, blood gases, cardiac output, multimodal analgesia, veterinary.

 

Efeitos cardio-pulmonares e ácido-base da infusão contínua de fentanil, cetamina e lidocaína em pacientes caninos ASA I

A combinação de fentanil, lidocaína e cetamina (FLK) tem sido amplamente utilizada em cirurgia canina como parte do protocolo analgésico. Alguns efeitos associados à sua aplicação foram descritos na literatura. O objetivo do presente trabalho foi avaliar os efeitos cardiopulmonares produzidos pela infusão de FLK e o uso de isoflurano durante a cirurgia em pacientes caninos ASA I. As amostras foram coletadas de nove fêmeas caninas de diferentes raças, idades e tamanhos apresentados para ovario-histerectomia e recebeu infusão contínua de FLK (0,08, 30 e 15 μg/kg/min, respectivamente) como parte do protocolo analgésico. Antes (tempo 1; T1) e durante (tempo 2; T2) a cirurgia fazia medições das frequências cardíaca e respiratória, pressão arterial não invasiva, índice e débito cardíaco, saturação arterial de oxigênio, dióxido de carbono expirado, temperatura, pressão parcial de dióxido de carbono e oxigênio, bicarbonato, pH no sangue, dióxido de carbono total e lactato no sangue. Os resultados de temperatura corporal e pH em T1 e T2 foram estatisticamente diferentes (p <0,05). Conclui-se que não houve diferença entre os efeitos das variáveis cardiorrespiratórias e hemodinâmicas em T1 e T2. Os resultados encontrados indicam que alterações no pH e temperatura foram devidas a fatores adicionais à infusão de FLK. Embora as variáveis cardiovasculares e hemodinâmicas não tenham sido significativas, foi possível observar uma melhora na perfusão tecidual e na estabilidade hemodinâmica.

Palavras-chave: analgesia multimodal, anestesia, gases sangüíneos, débito cardíaco, veterinária.


Palabras clave


analgesia multimodal, anestesia, gases en sangre, gasto cardíaco, veterinaria.

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