Fernanda Antunes

EFEITO ANALGÉSICO DO BUTORFANOL NA DOR SOMÁTICA EM GATOS ANESTESIADOS COM PROPOFOL

Professor, Departamento de Veterinaria, UFV, Vicosa, MG.RESUMOO propofol e um agente anestesico intravenoso usa-do para inducao e manutencao da anestesia, mas produz analge-sia limitada, havendo a necessidade do uso concomitante deanalgesicos. Avaliou-se o efeito analgesico do butorfanol na dorsomatica em gatos anestesiados com doses fracionadas de pro-pofol. Foram utilizados 16 animais, distribuidos aleatoriamenteem dois grupos. Os animais do grupo controle foram pre-tratadoscom 0,2mg/kg de acepromazina por via IM e, apos 15 minutos,receberam 6mg/kg de propofol por via IV. Os animais do grupotratamento foram pre-medicados com uma combinacao de ace-promazina (0,2mg/kg) e butorfanol (0,8mg/kg), administrados namesma seringa por via IM, e, apos 15 minutos, receberam 6mg/kgde propofol por via IV. Em ambos os grupos, a manutencao daanestesia foi feita com administracoes de propofol, na dose de3mg/kg, por via IV, sempre que necessario, durante 60 minutos. Anecessidade de readministracao de propofol foi verificada pelaresposta apresentada ao pincamento cutâneo, atraves de umapinca de Kocher. Avaliaram-se tambem as frequencias cardiaca erespiratoria, pressao arterial media, saturacao de oxiemoglobinae temperatura retal. A administracao de butorfanol causou ape-nas reducao nas frequencias cardiaca e respiratoria e na satura-cao de oxiemoglobina, em comparacao com o grupo controle,sem exercer influencia significativa sobre o periodo habil, a dosetotal administrada e o periodo de recuperacao do propofol.Concluiu-se que a adicao de butorfanol nao produziu analgesiasomatica em gatos anestesiados com doses fracionadas de pro-pofol.Palavras-chave: gato, felino, anestesia, propofol, butorfanol.SUMMARYPropofol is an intravenous anesthetic agent used forinduction and maintenance of anesthesia but produces limitedanalgesia, and concomitant use of analgesics is necessary. Theanalgesic effect of butorphanol in somatic pain in catsanesthetized with intermittent doses of propofol was evaluated.Sixteen animals were randomly assigned to 2 groups. Controlgroup animals were premedicated with IM acepromazine(0,2mg/kg) and after 15 minutes IV propofol (6mg/kg) wasadministered. Treatment group animals were premedicated withIM acepromazine (0,2mg/kg) and butorphanol (0,8mg/kg), mixedin the same syringe and after 15 minutes IV propofol (6mg/kg)was administered. In both groups anesthesia was maintained withrepeated injections of propofol (3mg/kg) as needed, during 60minutes. The need to complement propofol doses was determinedby reactions to a skin pinch with a Kocher hemostatic forceps.Heart rate, respiratory rate, mean blood pressure, rectal bodytemperature and oxyhemoglobin saturation were also recorded.Administration of butorphanol caused minimal changes incardiopulmonary variables compared to control group and didnot affect duration of anesthesia and total dose of propofol orrecovery period. We concluded that addition of butorphanol didnot produce somatic analgesia during anesthesia maintained withrepeated injections of propofol in cats.Key words: cat, feline, anesthesia, propofol, butorphanol.

New technique of intragastric sleeve: viability and survival in a pig model

Developing a less invasive, practical and cost-effective operative technique for obesity treatment represents a pressing need for our society. In this way, intragastric single port sleeve by endoplication was tested in six pigs during 18 weeks. Celiotomy was performed with animal placed in dorsal decubitus position. Single port gastrostomy was performed and double tobacco pouch sutures were made in fundic region, making a gastric sleeve. At the end, stomach layers and skin were closed in a conventional manner. Means and the standard deviations of surgical time were calculated. The procedure was simple and all animals survived; there were no significant blood loss and no intra and postoperative complications. The procedure was fast (67.4 minutes). The technique has the advantage of not requiring the use of mechanical sutures, making it less costly. The innovation of this procedure was the use of a single port gastrostomy device to perform an intraluminal sleeve. What made this technique less invasive were the use of a single port, nonmanipulation of the stomach intra-abdominally, ease of execution and no need of pneumoperitoneum. The new technique is acceptable and has reproducible viability, had a short procedure time without intra and postoperative complications.

Technical innovation: Intragastric Single Port Sleeve Gastrectomy (IGSG). A feasibility survival study on porcine model

PURPOSE To perform technically the laparoscopic sleeve gastrectomy (LSG) using a unique Intragastric Single Port (IGSG) in animal swine model, evidencing an effective and safe procedure, optimizing the conventional technique. METHODS IGSG was performed in 4 minipigs, using a percutaneous intragastric single port located in the pre-pyloric region. The gastric stapling of the greater curvature started from the pre-pyloric region towards the angle of His by Endo GIA™ system and the specimen was removed through the single port. In the postoperative day 30, the animals were sacrificed and submitted to autopsy. RESULTS All procedures were performed without conversion, and all survived 30 days. The mean operative time was 42 min. During the perioperative period no complications were observed during invagination and stapling. No postoperative complications occurred. Post-mortem examination showed no leaks or infectious complications. CONCLUSION Intragastric Single Port is a feasible procedure that may be a suitable alternative technique of sleeve gastrectomy for the treatment of morbid obesity.

Vascular endothelial growth factor association with angiopoietin 1 promotes improvement in ventricular function after ischemic cardiomyopathy induced in mini pigs

PURPOSE To investigate the safety and clinical, hemodynamic and tissue improvement ability in mini pigs undergoing cell and gene therapy for the treatment of acute myocardial infarction. METHODS Thirty-two mini pigs Br1 lineage, 12 months old, undergoing induction of acute myocardial infarction by occlusion of the diagonal branch of the paraconal coronary. They were divided into 4 groups: one control group and 3 treatment groups (cell therapy and gene cell therapy). Echocardiography reviews were performed on three occasions and histopathological analysis was performed after 4 weeks. Analysis of variance (ANOVA), Tukey and Wilcoxon tests, were performed. RESULTS Association of vascular endothelial growth factor (VEGF) with angiopoietin1 (Ang1) presented satisfactory results in the improvement of ventricular function following ischemic cardiomyopathy in mini pigs when compared to the results of the other treated groups. CONCLUSION The therapy with VEGF and the combination of VEGF with Ang1, promoted recovered function of the myocardium, characterized by reduced akinetic area and induction of neovascularization.

Transcolonic Perirectal NOTES Access (PNA): A feasibility study with survival in swine model

Transrectal access still has some unsolved issues such as spatial orientation, infection, access and site closure. This study presents a simple technique to perform transcolonic access with survival in a swine model series. A new technique for NOTES perirectal access to perform retroperitoneoscopy, peritoneoscopy, liver and lymphnode biopsies was performed in 6 pigs, using Totally NOTES technique. The specimens were extracted transanally. The flexible endoscope was inserted through a posterior transmural incision and the retrorectal space. Cultures of bacteria were documented for the retroperitoneal space and intra abdominal cavity after 14 days. Rectal site was closed using non-absorbable sutures. There was no bowel cleansing, nor preoperative fasting. The procedures were performed in 6 pigs through transcolonic natural orifice access using available endoscopic flexible instruments. All animals survived 14 days without complications, and cultures were negative. Histopathologic examination of the rectal closure site showed adequate healing of suture line and no micro abscesses. The results of feasibility and safety of experimental Transcolonic NOTES potentially brings new frontiers and future wider applications for minimally invasive surgery. The treatment of colorectal, abdominal and retroperitoneal diseases through a flexible Perirectal NOTES Access (PNA) is a promising new approach.

A possible relationship between gluconeogenesis and glycogen metabolism in rabbits during myocardial ischemia

Ischemia is responsible for many metabolic abnormalities in the heart, causing changes in organ function. One of modifications occurring in the ischemic cell is changing from aerobic to anaerobic metabolism. This change causes the predominance of the use of carbohydrates as an energy substrate instead of lipids. In this case, the glycogen is essential to the maintenance of heart energy intake, being an important reserve to resist the stress caused by hypoxia, using glycolysis and lactic acid fermentation. In order to study the glucose anaerobic pathways utilization and understand the metabolic adaptations, New Zealand white rabbits were subjected to ischemia caused by Inflow occlusion technique. The animals were monitored during surgery by pH and lactate levels. Transcription analysis of the pyruvate kinase, lactate dehydrogenase and phosphoenolpyruvate carboxykinase enzymes were performed by qRT-PCR, and glycogen quantification was determined enzymatically. Pyruvate kinase transcription increased during ischemia, followed by glycogen consumption content. The gluconeogenesis increased in control and ischemia moments, suggesting a relationship between gluconeogenesis and glycogen metabolism. This result shows the significant contribution of these substrates in the organ energy supply and demonstrates the capacity of the heart to adapt the metabolism after this injury, sustaining the homeostasis during short-term myocardial ischemia.

Oxigenação extracorpórea por membrana em cães sem auxílio circulatório

In humans, arteriovenous extracorporeal membrane oxygenation (AV-ECMO) is a life support technique capable to assume in part or totally lungs functions, when these are not able to promote appropriated hematosis. To know the viability of this method in dogs (Canis familiaris), the present study applied AV-ECMO in ten adult mixed-breed dogs, with expected three hours of duration to each experiment. In Group 1 (n=4), mechanical ventilation and dopamine continuous infusion were associated with the extracorporeal support. In Group 2 (n=6), any other measure of intensive care was used concomitantly AV-ECMO. Blood gas analysis and lactate levels were evaluated every 10 minutes and one hour, respectively, from arterial blood samples. Inotropic support improved the blood flow through the circuit promoting a better tissue perfusion with oxygenated blood, suggested by the lactate and mean arterial pressure levels measured. Mechanical ventilation used simultaneously with AV-ECMO was able to further improve levels of blood gases. Therefore, if applied along intensive care support, AV-ECMO is a viable technique for use in dogs with respiratory failure refractory to conventional treatments.

NOTES transvaginal em égua: estudo preliminar

A cirurgia endoscopica por orificios naturais e um novo conceito de abordagem endoscopico-cirurgica, que surge comoalternativa a cirurgia convencional, eliminando incisoes abdominais e complicacoes relacionadas. Ela e realizada pororificios como estomago, ânus e vagina. A proposta deste estudo foi descrever nova tecnica cirurgica minimamente invasivapara acesso a cavidade abdominal, por NOTES (Natural Orifice Transluminal Endoscopic Surgery) transvaginal em eguas.Foi realizado o acesso atraves do fornix vaginal para um inventario da cavidade abdominal em duas eguas. Para tal foirealizada uma sedacao previa com Detomidina intravenosa e lidocaina pela via epidural. O acesso foi feito com auxilio de umtrocater-cânula dorsolateral direita a cervix; que em seguida foi substituido por um overtube e o endoscopio flexivel foiinserido atraves deste. Foi realizada exploracao seriada da cavidade abdominal. O acesso foi realizado facilmente semcomplicacoes de trans e pos-operatorios. Foi visualizado o antimero direito da cavidade abdominal e suas estruturasanatomicas. O metodo evidenciou eficiencia e minima invasibilidade para exploracao de visceras abdominais em femeasequinas, ficando clara sua grande relevância para diagnostico de patologias abdominais como seu uso para realizacao debiopsias.

Influência do óxido nitroso na anestesia pela associação tiletamina-zolazepam, em cães

Visando avaliar a influencia do oxido .nitroso na anestesia pela associacao tiletamina-zolazepam (T-Z), foram utilizadas 24cadelas, distribuidas aleatoriamente em dois grupos (G1 e G2), nas quais a ovario-histerectomia foi executada. Todos osanimais foram pre-tratados com 1 ,O mg/kg de levomepromazina por via IV e apos 15 minutos receberam 2,0 mg/kg daassociacao T-Z, pela mesma via, como inducao anestesica. Nos animais do G1, a anestesia foi mantida por reaplicacoessucessivas T-Z na dose de 1 ,O mg/kg, via IV, sempre que necessario; enquanto no G2, os animais receberam 70% de oxidonitroso e 30% de 0 2 , alem das reaplicacoes de T-Z. O periodo anestesico foi de 60 minutos. A analise das variaveis fisiologicase clinicas obtidas mostrou que a adicao do oxido nitroso no G2 nao foi capaz de reduzir a dose da associacao T-Z necessariaa manutencao da anestesia, permitindo concluir que seu uso como complemento da anestesia pela associacao T-Z, naooferece vantagens apreciaveis, em caes.