Difusión analgésica de lidocaína administrada a través de un catéter perilesional en hembras caninas sometidas a mastectomía: un reporte de caso

Diego Moreno Velásquez, Luis Adolfo Vergara Saldarriaga, Alejandra Uribe Rendón, Nathalia María Correa Valencia

Resumen


La mastectomía regional en caninos se considera un procedimiento
quirúrgico con un grado de dolor intenso, por lo que exige una terapéutica analgésica posquirúrgica efectiva que actúe a favor del bienestar de los pacientes. El manejo farmacológico analgésico sistémico convencional en pacientes de carácter oncológico es deficiente y está fundamentado principalmente en antinflamatorios no esteroidales (AINEs) u opioides de baja potencia. El objetivo del presente reporte es describir el manejo analgésico posmastectomía en dos hembras caninas, mediante el uso de lidocaína como opción fármaco-terapéutica administrada a través de un catéter de difusión analgésica perilesional (MILA®). Ambos pacientes fueron sometidos a mastectomía regional. Luego de retirar la masa mamaria para cada caso, se instauró un catéter perilesional y se administró lidocaína a 2 mg/kg/ hora de forma intralesional, mediante difusión constante por medio de un catéter y una jeringa perfusora. Se realizaron mediciones de variables fisiológicas y de dolor mediante la escala de la Universidad de Melbourne (UMPS) en ambos pacientes cada 2 horas (T0-T12) durante 24 horas. Ambos pacientes mostraron un descenso en el score de la UMPS durante el periodo de observación posquirúrgica y no hubo cambios significativos en las mediciones de las variables fisiológicas. La infusión intralesional de lidocaína aplicada en los dos pacientes sometidos a mastectomía del presente reporte logró un estado de analgesia posquirúrgico efectivo.

 

Analgesic diffusion of lidocaine administered through a wound soaker catheter in female canines undergoing mastectomy: a case report

The regional mastectomy in canines is considered as an intense-pain degree surgical procedure in bitches, which requires an effective post-surgical analgesic therapy for the well-being of patients. The conventional systemic analgesic pharmacological management in oncological patients is deficient and is mainly based on non-steroidal anti-inflammatory drugs (NSAIDs) and/or low potency opioids. The present report aimed to describe post-mastectomy analgesic management in two bitches, using lidocaine as a drug-therapeutic option administered through a perilesional analgesic diffusion catheter (MILA®). Both patients were subjected to regional mastectomy. After removing the breast mass for each case, a perilesional catheter was placed and the lidocaine was administered at 2 mg/kg/hour intralesionally, by constant diffusion through a catheter and a perfusion syringe. Measurements of physiological and pain variables were collected using the University of Melbourne Scale (UMPS) in both patients every 2 hours (T0-T12) for 24 hours. Both patients showed a decrease in UMPS score during the post-surgical observation period and there were no significant changes in the measurements of the physiological variables. The intralesional infusion of lidocaine applied in the two patients subjected to mastectomy on this report achieved an effective post-surgical analgesia state.

Keywords: local anesthetic, pain, oligoanalgesia, UMPS.

 

Difusão analgésica de lidocaína administrada por um cateter perilesional em cadelas submetidas à mastectomía: um relato de caso

A mastectomía regional em caninos é considerada um procedimento cirúrgico com grau de dor intenso, que requer uma terapia analgésica pós-cirúrgica efetiva que atue em o bem-estar dos pacientes. A terapia farmacológica sistémica analgésico convencional nestes pacientes de características oncológicas é mau e baseada principalmente na antinflamatorios não esteroide (AINE) e/ou de opioides baixa potência. O objetivo deste trabalho é descrever a terapia analgésica pós-mastectomía dois cães fêmeas, através da utilização de lidocaína como opção terapêutico medicamentoso administrado o fármaco através de um cateter de difusão perilesional analgésico (MILA®). Duas cadelas foram submetidas a mastectomía regional. Após a remoção da massa mamária para cada caso, um cateter perilesional foi colocado e lidocaína foi administrada a 2 mg/kg/hora por via intralesional, por difusão constante através de cateter e seringa de perfusão. Medidas de variáveis fisiológicas e de dor foram feitas usando a escala da Universidade de Melbourne (UMPS) em ambos os pacientes a cada 2 horas (T0-T12) por 24 horas. Ambos pacientes mostraram uma diminuição no escore de dor de UMPS durante o período de observação pós-cirúrgica e não houve mudanças significativas nas medidas das variáveis fisiológicas. A infusão intralesional de lidocaína aplicada nas duas cadelas submetidos à mastectomía deste relato alcançou um estado analgésico pós-operatório eficaz.

Palavras-chave: anestésico local, dor, oligoanalgesia, UMPS.


Palabras clave


anestésico local, dolor, oligoanalgesia, UMPS.

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