Sílvia Elaine Rodolfo de Sá Lorena

Postoperative analgesic effects of intravenous, intramuscular, subcutaneous or oral transmucosal buprenorphine administered to cats undergoing ovariohysterectomy

OBJECTIVE To compare the postoperative analgesic effects of intravenous (IV), intramuscular (IM), subcutaneous (SC) or oral transmucosal (OTM) buprenorphine administered to cats undergoing ovariohysterectomy. STUDY DESIGN Randomized, prospective and blinded clinical trial. ANIMALS 100 female cats. METHODS Cats were assigned to receive 0.01 mg kg(-1) of buprenorphine administered by the IV, IM, SC or OTM route (n = 25/group). Buprenorphine was made up to 0.3 mL with 0.9% saline. DIVAS (0-100 mm) and simple descriptive scale (SDS) (from 0 to 4) pain and sedation scores were assigned to each cat before and 1, 2, 3, 4, 6, 8, 12 and 24 hours after ovariohysterectomy. Buprenorphine and carprofen were administered for rescue analgesia. Data were analyzed using anova and Fishers exact test (p < 0.05). RESULTS There were no significant differences between groups for breed, body weight, anesthetic time or surgery time (p > 0.05). There were no significant differences between groups for sedation scores at any time. SDS pain scores did not detect any differences between groups (p > 0.05). DIVAS pain scores after OTM administration were significantly higher than IV and IM administration at 1 hour and at 3, 4, 6, 8 and 12 hours, respectively (p < 0.05). DIVAS pain scores after SC administration were significantly higher than IV and IM administration at 2 hours and at 2, 3, 4, 8, 12 and 24 hours (p < 0.05), respectively. Six, four, 13 and 17 cats that received IV, IM, SC and OTM buprenorphine required rescue analgesia, respectively. There was a significantly higher incidence of treatment failure in cats that received SC and OTM buprenorphine compared with cats that received IV and IM buprenorphine (p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE IV and IM administration of buprenorphine provided better postoperative analgesia than SC or OTM administration of the drug and these routes of administration should be preferred when buprenorphine is administered to cats.

Current attitudes regarding the use of perioperative analgesics in dogs and cats by Brazilian veterinarians.

OBJECTIVE To correlate the demographic data of Brazilian veterinarians with their use of, attitudes towards, knowledge of and preference for continuing education regarding use of analgesics in small animal practice. STUDY DESIGN Prospective survey. METHODS The questionnaire was composed of sections pertaining to demographics, personal data, use of analgesics in general and specific procedures, analgesia used, and attitudes towards the assessment and relief of pain. The descriptive statistics with frequency analysis was performed using sas for Windows 9.1.3. Chi-square for simple comparisons test was used. RESULTS Questionnaires were obtained from 1298 small animal veterinarians. Women and younger graduates attributed higher pain scores than men and older graduates but the frequency and duration of analgesic treatment did not differ between genders. The most commonly used opioids were tramadol (79%) and morphine (51%). NSAIDs of choice were meloxicam (81%) and ketoprofen (70%). Cats received lower pain scores for laparotomy, orchiectomy and dental procedures than dogs. Practical experience (64%) and national (47%) and regional meetings (43%) were the main sources of information for identifying and treating pain in small animals. CONCLUSIONS Although the number of Brazilian veterinarians believed that their knowledge in the area was lower than in other countries, the focus in pain management was similar or higher than in other countries, showing a good attitude in pain relief in animals.

Post-operative analgesic effects of butorphanol or firocoxib administered to dogs undergoing elective ovariohysterectomy

OBJECTIVE To compare the post-operative analgesic effects of butorphanol or firocoxib in dogs undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded, clinical trial. ANIMALS Twenty-five dogs >1 year of age. METHODS Dogs received acepromazine intramuscularly (IM), 0.05 mg kg(-1) and either butorphanol IM, 0.2 mg kg(-1) (BG, n = 12) or firocoxib orally (PO), 5 mg kg(-1) (FG, n = 13), approximately 30 minutes before induction of anesthesia with propofol. Anesthesia was maintained with isoflurane. Ovariohysterectomy was performed by the same surgeon. Pain scores using the dynamic and interactive visual analog scale (DIVAS) were performed before and at 1, 2, 3, 4, 6, 8 and 20 hours after the end of surgery by one observer, blinded to the treatment. Rescue analgesia was provided with morphine (0.5 mg kg(-1)) IM and firocoxib, 5 mg kg(-1) (BG only) PO if DIVAS >50. Groups were compared using paired t-tests and Fishers exact test (p < 0.05). Data are presented as mean ± SD. RESULTS The BG required significantly less propofol (BG: 2.6 ± 0.59 mg kg(-1); FG: 5.39 ± 0.7 mg kg(-1)) (p < 0.05) but the anesthesia time was longer (BG: 14 ± 6, FG: 10 ± 4 minutes). There were no differences for body weight (BG: 7.9 ± 5.0, FG: 11.5 ± 4.6 kg), sedation scores, and surgery and extubation times (BG: 10 ± 2, 8 ± 5 minutes; FG: 9 ± 3, 8 ± 4 minutes, respectively) (p > 0.05). The FG had significantly lower pain scores than the BG at 1, 2 and 3 hours following surgery (p < 0.05). Rescue analgesia was administered to 11/12 (92%) and 2/13 (15%) dogs in the BG and FG, respectively (p < 0.05). CONCLUSION AND CLINICAL RELEVANCE Firocoxib produced better post-operative analgesia than butorphanol. Firocoxib may be used as part of a multimodal analgesia protocol but may not be effective as a sole analgesic.OBJECTIVE To compare the post-operative analgesic effects of butorphanol or firocoxib in dogs undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded, clinical trial. ANIMALS Twenty-five dogs >1 year of age. METHODS Dogs received acepromazine intramuscularly (IM), 0.05 mg kg-1 and either butorphanol IM, 0.2 mg kg-1 (BG, n = 12) or firocoxib orally (PO), 5 mg kg-1 (FG, n = 13), approximately 30 minutes before induction of anesthesia with propofol. Anesthesia was maintained with isoflurane. Ovariohysterectomy was performed by the same surgeon. Pain scores using the dynamic and interactive visual analog scale (DIVAS) were performed before and at 1, 2, 3, 4, 6, 8 and 20 hours after the end of surgery by one observer, blinded to the treatment. Rescue analgesia was provided with morphine (0.5 mg kg-1) IM and firocoxib, 5 mg kg-1 (BG only) PO if DIVAS > 50. Groups were compared using paired t-tests and Fishers exact test (p < 0.05). Data are presented as mean ± SD. RESULTS The BG required significantly less propofol (BG: 2.6 ± 0.59 mg kg-1; FG: 5.39 ± 0.7 mg kg-1) (p < 0.05) but the anesthesia time was longer (BG: 14 ± 6, FG: 10 ± 4 minutes). There were no differences for body weight (BG: 7.9 ± 5.0, FG: 11.5 ± 4.6 kg), sedation scores, and surgery and extubation times (BG: 10 ± 2, 8 ± 5 minutes; FG: 9 ± 3, 8 ± 4 minutes, respectively) (p > 0.05). The FG had significantly lower pain scores than the BG at 1, 2 and 3 hours following surgery (p < 0.05). Rescue analgesia was administered to 11/12 (92%) and 2/13 (15%) dogs in the BG and FG, respectively (p < 0.05). CONCLUSION AND CLINICAL RELEVANCE Firocoxib produced better post-operative analgesia than butorphanol. Firocoxib may be used as part of a multimodal analgesia protocol but may not be effective as a sole analgesic.

Attitude of Brazilian veterinarians in the recognition and treatment of pain in horses and cattle

OBJECTIVE The objective of this study was to assess the use of analgesics, describe the attitudes of Brazilian veterinarians towards pain relief in horses and cattle and evaluate the differences due to gender, year of graduation and type of practice. STUDY DESIGN Prospective survey. METHODS Questionnaires were sent to 1000 large animal veterinarians by mail, internet and delivered in person during national meetings. The survey investigated the attitudes of Brazilian veterinarians to the recognition and treatment of pain in large animals and consisted of sections asking about demographic data, use of analgesic drugs, attitudes to pain relief and to the assessment of pain. Descriptive statistics were used to analyze frequencies. Simple post hoc comparisons were performed using the chi-square test. RESULTS Eight hundred questionnaires were collected, but 87 were discarded because they were incomplete or blank. The opioid of choice for use in large animals was butorphanol (43.4%) followed by tramadol (39%). Flunixin (83.2%) and ketoprofen (67.6%) were the most frequently used NSAIDs by Brazilian veterinarians. Respondents indicated that horses received preoperative analgesics for laparotomy more frequently (72.9%) than cattle (58.5%). The most frequently administered preoperative drugs for laparotomy in horses were flunixin (38.4%) and xylazine (23.6%), whereas the preoperative drugs for the same surgical procedure in cattle were xylazine (31.8%) and the local administration of lidocaine (48%). Fracture repair was considered the most painful surgical procedure for both species. Most veterinarians (84.1%) believed that their knowledge in this area was not adequate. CONCLUSIONS AND CLINICAL RELEVANCE Although these Brazilian veterinarians thought that their knowledge on recognition and treatment of pain was not adequate, the use of analgesic in large animals was similar in Brazil to that reported in other countries.

Goniometria dos membros pélvicos de pacas (Cuniculus paca) criadas em cativeiro

The aim of this study was to evaluate by goniometry the hind limbs of pacas raised in captivity. Eight mature pacas (Cuniculus paca), three females and five males, weighing 6.0-8.2 kg, were used. The quantity of joint flexion and extension motion of the hip joint, stifle joint and tarsocrural joint was measured using a plastic standard goniometer. Under dissociative anesthesia, two measures were made for each member in each animal by the same observer at an interval of one week. There were no statistical differences of the quantity of joint motion between the moments. The flexion and extension angles varied from 1o to 5o in each moment for the same observer. The mean values of the angles of flexion and extension were, respectively, 43.96o±7.62 and 118.31o±9.79 for hip joint, 54.25o±10.24 and 131.53o±7.89 for stifle joint, and 45.94o±7.16 and 145.03o±5.06 for tarsocrural joint. Thus, it was observed that the range of motion of the pacas is greater in the tarsocrural joint, followed respectively by stifle and hip joints.

Curva de aprendizado em cirurgia aórtica videolaparoscópica: estudo experimental em porcos

CONTEXTO: A cirurgia videolaparoscopica (CVL) vem evoluindo como alternativa cirurgica menos invasiva para o tratamento da doenca aterosclerotica oclusiva aorto-iliaca e do aneurisma da aorta abdominal. Poucos estudos avaliaram objetivamente a curva de aprendizado com essa tecnica em cirurgia vascular. OBJETIVO: Avaliar objetivamente os tempos e a evolucao de cada passo cirurgico e demonstrar a exequibilidade dessa tecnica. METODOS: Entre outubro 2007 e janeiro de 2008, dois cirurgioes vasculares iniciantes na CVL operaram, apos cursos e treinamentos, seis porcos consecutivos, com disseccao aortica e interposicao de um enxerto de dacron em um segmento da aorta infra-renal abdominal, com tecnica totalmente laparoscopica. RESULTADOS: Todos os tempos cirurgicos foram decrescentes ao longo do estudo, apresentando reducao de 45,9% no tempo total de cirurgia, 85,8% no tempo de disseccao da aorta, 81,2% na exposicao da aorta, 55,1% no clampeamento total, 71% na confeccao da anastomose proximal e 64,9% na anastomose distal. CONCLUSAO: O presente estudo mostrou que os resultados tecnicos satisfatorios da CVL vascular ocorreram somente apos longa curva de aprendizado, que foi decrescente ao longo do tempo, a medida que aumentou a experiencia e vivencia com os materiais e com a visao nao-estereoscopica. Essa tecnica pode ser realizada com perfeicao por cirurgioes vasculares desde que facam cursos especializados, com treinamento em simuladores e animais, e desde que busquem constante aprimoramento a fim de conseguir resultados similares aos obtidos com a cirurgia convencional.

Avaliação radiográfica de cães com displasia coxofemoral tratados pela sinfisiodese púbica

Avaliou-se a progressao dos sinais radiograficos de caes com displasia coxofemoral ou potencialmente displasicos tratados pela tecnica da sinfisiodese pubica. Foram utilizados 14 caes, seis machos e oito femeas, com idades entre quatro e seis meses. Apos exame fisico, procedeu-se ao exame radiografico para avaliacao da articulacao coxofemoral, segundo padrao estabelecido pelo Colegio Brasileiro de Radiologia Veterinaria. Tres deles foram tambem avaliados pelo metodo PennHIP. Pelo historico clinico, nove (64%) animais foram trazidos por manifestarem sinais de dificuldade locomotora com os membros pelvicos, manifestada especialmente por claudicacao unilateral ou bilateral e dificuldade de se levantar. Cinco (36%) caes nao tinham qualquer sinal clinico, e em quatro (29%) realizou-se o exame radiografico como prevencao. O sinal fisico mais evidente foi dor a palpacao da articulacao coxofemoral, e dois (14%) caes apresentaram sinal de Ortolani positivo. Com excecao de um cao que apresentou infeccao nos pontos cutâneos, todos os demais evoluiram sem complicacoes no periodo pos-operatorio. Radiograficamente houve progressao das lesoes articulares em seis (43%) animais e oito (57%) mantiveram a classificacao inicial. Concluiu-se que caes tratados pela sinfisiodese pubica nao apresentam melhora dos sinais radiograficos iniciais.