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Abstract(s)
A rutura do ligamento cruzado cranial é uma das patologias articulares de
maior incidência nos cães, e consequentemente, é considerada uma das principais
causas que predispõem a doença articular degenerativa ou ao seu agravamento. Tendo
em vista a necessidade de realização de técnicas cirúrgicas e a importância do
bem-estar do animal perante a dor aguda, os objetivos dos anestesistas passam por
proporcionar relaxamento muscular e analgesia adequados. O presente estudo
pretende comparar três protocolos de maneio da dor perioperatória em cães
saudáveis submetidos a osteotomia de nivelamento do platô tibial. Foram
acompanhados trinta cães (n=30) com rutura do ligamento cruzado cranial, divididos
em 3 grupos e a cada um foi aplicado um protocolo diferente para maneio da dor (com
utilização ou não de analgésicos opióides, e utilização ou não de bloqueio ecoguiado
dos nervos periféricos do membro pélvico intervencionado). Atendendo ao estudo
comparativo de pontuações de dor, conclui-se que os três protocolos se mostraram
eficazes no maneio da dor pós-operatória 1, 2 e 3 horas após a cirurgia. O grupo em
que se utilizaram opióides em conjunto com bloqueio dos nervos periféricos, provou
ser o protocolo mais eficaz, com uma pontuação média de dor de 3.73 no final das 3
horas. O grupo com aplicação de bloqueio de nervos periféricos de forma exclusiva,
apresentou um pain score médio de 3.96 e provou ser possível a realização da técnica
cirúrgica, conseguindo uma anestesia livre de opióides garantindo a analgesia e
conforto do paciente. Este estudo apoia o esforço contínuo em direção a uma
abordagem multimodal para a analgesia veterinária em combinação com pontuações de
dor baixas para os grupos em que foi usado bloqueio dos nervos periféricos.
Rupture of the cranial cruciate ligament is one of the most common joint pathologies in dogs and consequently it is considered one of the main issues that predispose to degenerative joint disease or its worsening. Bearing in mind the need to perform surgical techniques and the importance of the animal's well-being in the face of acute pain, the objectives of anesthetists are to provide adequate muscle relaxation and analgesia. The present study aims to compare three perioperative pain management protocols in healthy dogs undergoing tibial platô leveling osteotomy. Thirty dogs (n=30) with rupture of the cranial cruciate ligament were divided into 3 groups and each one was applied a different protocol for pain management (with or without the use of opioid analgesics, and the use or not of ultrasound-guided nerve block of the peripheral nerves of the intervened pelvic limb). Considering the comparative study of pain scores, it is concluded that the three protocols were effective in managing postoperative pain 1, 2 and 3 hours after surgery. The group using opioids in conjunction with peripheral nerve blocks proved to be the most effective protocol, with an average pain score of 3.73 at the end of the 3 hours. The group that exclusively applied peripheral nerve blocks had an average pain score of 3.96 and proved that it was possible to perform the surgical technique, achieving opioid-free anesthesia without compromising analgesia and patient comfort. This study supports the continued effort toward a multimodal approach to veterinary analgesia in combination with low pain scores for groups in which peripheral nerve blocks were used.
Rupture of the cranial cruciate ligament is one of the most common joint pathologies in dogs and consequently it is considered one of the main issues that predispose to degenerative joint disease or its worsening. Bearing in mind the need to perform surgical techniques and the importance of the animal's well-being in the face of acute pain, the objectives of anesthetists are to provide adequate muscle relaxation and analgesia. The present study aims to compare three perioperative pain management protocols in healthy dogs undergoing tibial platô leveling osteotomy. Thirty dogs (n=30) with rupture of the cranial cruciate ligament were divided into 3 groups and each one was applied a different protocol for pain management (with or without the use of opioid analgesics, and the use or not of ultrasound-guided nerve block of the peripheral nerves of the intervened pelvic limb). Considering the comparative study of pain scores, it is concluded that the three protocols were effective in managing postoperative pain 1, 2 and 3 hours after surgery. The group using opioids in conjunction with peripheral nerve blocks proved to be the most effective protocol, with an average pain score of 3.73 at the end of the 3 hours. The group that exclusively applied peripheral nerve blocks had an average pain score of 3.96 and proved that it was possible to perform the surgical technique, achieving opioid-free anesthesia without compromising analgesia and patient comfort. This study supports the continued effort toward a multimodal approach to veterinary analgesia in combination with low pain scores for groups in which peripheral nerve blocks were used.
Description
Keywords
bloqueio dos nervos periféricos escala de dor dor osteotomia de nivelamento do platô tibial peripheral nerve block pain scale pain tibial platô leveling osteotomy