REVISTA

Eficacia de la morfina epidural lumbar o torácica para toracotomia en perros

Descripción: Produce una analgesia perioperatora similar pero más prolongada en la zona torácica (T5-T6) que la lumbar (L6) en perros

TITULO FUENTE ORIGINAL:

Evaluation of analgesic and physiologic effects of epidural morphine administered at a thoracic or lumbar level in dogs undergoing thoracotomy

AUTORES:

Carregaro AB, Freitas GC, Lopes C, Lukarsewski R, Tamiozzo FS, Santos RR

REVISTA ABREV.:

Vet Anaesth Analg

AÑO:

2014

REFERENCIA:

41(2):205-11

RESUMEN ORIGINAL:

OBJECTIVE: To evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy.
STUDY DESIGN: Prospective, randomized, blinded trial.
ANIMALS: Fourteen mixed-breed dogs, weighing 8.6 ± 1.4...
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OBJECTIVE: To evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy.
STUDY DESIGN: Prospective, randomized, blinded trial.
ANIMALS: Fourteen mixed-breed dogs, weighing 8.6 ± 1.4 kg.
METHODS: The animals received acepromazine (0.1 mg kg⁻¹) IM and anesthesia was induced with propofol (4 mg kg)⁻¹ IV. The lumbosacral space was punctured and an epidural catheter was inserted up to the region between the sixth and seventh lumbar vertebrae (L, n = 6) or up to the fifth or sixth intercostal space (T, n = 8). The dogs were allowed to recover and after radiographic confirmation of correct catheter position, anesthesia was reinduced with propofol IV and maintained with 1.7% isoflurane. Following stabilization of monitored parameters, animals received morphine (0.1 mg kg⁻¹) diluted in 0.9% NaCl to a final volume of 0.25 mL kg⁻¹ via the epidural catheter, and after 40 minutes, thoracotomy was initiated. Heart rate and rhythm, systolic, mean and diastolic arterial pressures, respiratory rate, arterial hemoglobin oxygen saturation, partial pressure of expired CO₂ and body temperature were measured immediately before the epidural administration of morphine (0 minute) and every 10 minutes during the anesthetic period. The Melbourne pain scale and the visual analog scale were used to assess postoperative pain. The evaluation began 3 hours after the epidural administration of morphine and occurred each hour until rescue analgesia.
RESULTS: There were no important variations in the physiological parameters during the anesthetic period. The post-operative analgesic period differed between the groups, being longer in T (9.9 01.6 hours) compared with L (5.8 ± 0.8 hours).
CONCLUSIONS: The use of morphine, at a volume of 0.25 mL kg 0.1, administered epidurally over the thoracic vertebrae provided longer lasting analgesia than when deposited over the lumbar vertebrae

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