Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches

IV Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches: a preliminary feasibility stud

Comparação da dor pós-operatória em cães versus gatos após orquiectomia versus ovariohisterectomia

Veterinarians attribute a higher pain scores and give more analgesics to dogs compared to cats. Both female dogs and cats receive more analgesia than males for the same surgical procedures. This study aimed to compare the expression of pain after orquiectomy and ovariohisterectomy of the same species and between the canine and feline species undergoing contraceptive surgery. Cats (24) and dogs (24) were enrolled in the study, with the same number of males and females. The animals were admitted 24 hours prior to the study for adaptation to the hospital environment and the observer. Meloxicam (0.1 mg/kg P.O.) was administered two hours before the surgical procedure. Pain scales were applied before (basal) and 1, 2, 4, 8 and 24 hours after surgery (M1, M2, M4, M8 and M24 respectively). Glasgow Composite Measure Pain Scale (GCMS) and Melbourne pain scale (MPS) were used in dogs, and UNESP-Botucatu Multidimensional Composite Pain Scale (UBMCP) in cats. When the score was above 33% for GCMS or 27% for MPS, analgesic rescue was given (morphine, 0.5 mg/kg for dogs and 0.3 mg/kg for cats). In both species the visual analogue pain scale (VAS) and sedation were recorded. Mann-Whitney was used to compare data between male and female (P < 0.05). Kruskall-Wallis was used to compare differences among groups, followed by Dunn test (P < 0.05). Friedman test compared differences along time (P < 0.05). When compared to baseline female dogs and cats had greater VAS from 1 to 4 h, male dogs and cats from 1 to 8 h and from 1 to 2 h after surgery, respectively. VAS values were higher in female dogs from 1 to 8 h than in male ones, and in female cats this value were higher at 4 h, compared to male cats. In GCMS, scores were greater compared to baseline for females between 1 and 4 h after surgery and at 1 h compared to males. There was no difference for MPS. For UBMCP, greater scores were observed in females compared to males between 1 and 2 h and at 2 h ...Historicamente os profissionais veterinários atribuem escores mais altos de dor e maior emprego de analgésicos na espécie canina em relação à felina e fêmeas em relação aos machos. O objetivo deste foi comparar a expressão da dor entre orquiectomia e ovariohisterectomia na mesma espécie e entre as espécies canina e felina submetidos à cirurgia contraceptiva. Utilizaram-se 48 animais, 12 machos e 12 fêmeas da espécie felina de raças variadas, com idade média 12 ± 4,32 e 8 ± 2,54 meses e massa corpórea de 3,9 ± 0,96 e 2,58 ± 0, 41 kg respectivamente, e 12 machos e 12 fêmeas da espécie canina, de raças variadas, com idade média de 20,8 ± 13,7 e 44 ± 23,6 meses e massa corpórea 20,3 ± 12,2 e 14,8 ± 8,6 kg respectivamente. Administrou-se meloxicam 0,1 mg/kg via oral (VO) duas horas antes do procedimento. Avaliou-se a dor antes (basal) e 1, 2, 4, 8 e 24 horas após a cirurgia. Para determinar os escores de dor em cães utilizou-se a Escala de Dor de Glasgow Modificada (EDGM) e da Universidade de Melbourne (EDUM). Para os gatos empregou-se a Escala de Dor Multidimensional da Unesp-Botucatu (EDMUB). Utilizaram-se a escala analógica visual para dor (EAV) e escala de sedação em ambas as espécies. Quando a pontuação era maior que 33% e 27% do valor total da EDGM e EDMUB respectivamente, realizava-se resgate analgésico com morfina. Como as variáveis não apresentaram distribuição normal, empregou-se o teste de Friedman e Mann-Whitney, para comparar as diferenças ao longo do tempo e entre os grupos em cada momento, respectivamente. Para comparação entre mais de dois grupos, utilizou-se o teste Kruskall-Wallis, seguido do teste de Dunn. Para diferenças de frequência de resgates analgésicos entre os grupos utilizou-se o teste exato de Fisher. Consideraram-se as diferenças significantes quando P < 0,05. As fêmeas de ambas as espécies apresentaram aumento da EAV de 1 a 4 h, os cães de 1 a 8 h e os gatos de ..

Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs<br> Efeitos da infusão intravenosa contínua de fármacos anestésicos ou analgésicos sobre a anestesia geral com isoflurano: Estudo retrospectivo em 200 cães

Constant rate infusion (CRI) shows several advantages in balanced anesthesia, such as reduction of requirement for inhaled anesthetics and control of pain. The most commonly used drugs in these protocols are local anesthetics, dissociative, and opioids, which may be administered alone or in combinations. We evaluated the records of 200 dogs that underwent various surgical procedures with anesthetic or analgesic CRI in the perioperative period during 2011 and 2012 at the Veterinary Hospital of Franca University (Unifran), and identified possible complications during the transoperative period. Records evaluated included clinical state, laboratory tests, drugs used in premedication and induction, and CRI protocol. Acepromazine and morphine were the main drugs used in premedication. Propofol was used to induce anesthesia alone or in combination with other agents. We evaluated records of the 25 different CRI protocols. Fentanyl was the main drug employed in CRI, either alone or in combination. There were 128 episodes of anesthetic complications during CRI;the most common were hypotension, hypertension, and tachycardia, which occurred in 43 (32%), 35 (26.3%), and 19 (14.2%) dogs, respectively. Cardiac arrhythmia was reported in only 4 dogs. Signs of respiratory depression were present in dogs treated with 6 different CRI protocols. The consumption of isoflurane (vol %) reduced between 15.7% and 21.05% after 30minutes of the CRI in the fentanyl and fentanyl–lidocaine–ketamine CRI groups (p<0.05). In conclusion, CRI is a valid component of balanced anesthesia in dogs, safe, and has a low incidence of adverse effects. However, future studies are warranted to describe the results of the clinical use of CRI to better characterize and refine this technique. <p><p>O uso de técnicas de infusão contínua (IC) possui inúmeras vantagens na anestesia balanceada, como a redução do requerimento de anestésicos inalatórios e controle da dor. Os fármacos mais comumente utilizados nestes protocolos são os anestésicos locais, dissociativos e opioides, que podem ser administrados isoladamente ou em associações. Foram avaliados os prontuários de 200 cães que foram submetidos a diversos procedimentos cirúrgicos com IC de anestésicos ou analgésicos no período perioperatório durante 2011 e 2012 no Hospital Veterinário da Universidade de Franca (Unifran). Foram identificadas possíveis complicações durante o período trans-operatório. Os registros avaliados incluíram estado clínico, exames laboratoriais, fármacos utilizados na pré-medicação e indução, e protocolos de IC. Acepromazina e morfina foram os principais fármacos usados na pré-medicação. O propofol foi utilizado para induzir a anestesia, isolado ou em associação com outros agentes. Foram avaliados os registros de 25 protocolos diferentes de IC. O fentanil foi o principal fármaco utilizado na IC, isoladamente ou em associação. Houve 128 episódios de complicações anestésicas durante a IC; os mais comuns foram hipotensão, hipertensão e taquicardia, que ocorreram em 43 (32%), 35 (26,3%), e 19 (14,2%) cães, respectivamente. Arritmia cardíaca foi relatada em apenas 4 cães. Sinais de depressão respiratória estiveram presentes em cães tratados com 6 diferentes protocolos de IC, especialmente com fentanil. O consumo de isoflurano (vol.%) reduziu entre 15,7% e 21,05%, após 30 minutos da IC nos grupos fentanil e fentanil-lidocaína-cetamina (p <0,05). Em conclusão, a IC é um componente válido da anestesia balanceada em cães, segura e tem baixa incidência de efeitos adversos. No entanto, estudos futuros são necessários para descrever os resultados do uso clínico da IC para melhor caracterizar e aperfeiçoar esta técnica

Use of the Angularis Oris Axial Pattern Buccal Flap for the Correction of Facial Defects in Six Dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions.Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9 years’ old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, wich center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however, regardless the complication, all patients had successful wound healing in 15 to 21 days after surgery. Also in two of the four suture dehiscence episodes, the cause of dehiscence was secondary to trauma and not the surgery.Discussion: The reconstruction of facial defects is noteworthy due the limited availability of flaps that can reach the region without excessive tension or healing complications. The angularis oris axial buccal flap pattern is the nearest flap to close defect in the intermandibular, temporal or labial regions. In the cases reported, it is possible to observe that the most frequent complication was suture dehiscence, but it occurred mostly in a small proportion of the flap, allowing healing in the expected time.The surgical planning is an important factor for reconstructive surgeries, so that there is enough tissue for the closure of the recipient and donor site, without tension over the flap or interference with tissue function and aesthetics. Despite the suture dehiscence in some of the cases, all patients showed adequate final recovery, since they returned to normal function with satisfactory cosmetic appearance.The angularis oris axial pattern buccal flap was applied in the correction of defects easily and all patients returned to normal function with satisfactory cosmetic appearance