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      Efeitos fetais e maternos do propofol, etomidato, tiopental e anestesia epidural, em cesariana eletivas de cadelas Translated title: Fetal and maternal effects of propofol, etomidate, tiopental and epidural anesthesia, in bitches elective caesarian section

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          Abstract

          O objetivo deste trabalho foi comparar os efeitos entre os fármacos indutores de anestesia como propofol, etomidato e tiopental, e a anestesia epidural com lidocaína seguida de indução, em cadelas submetidas à cesariana, e seus neonatos. Para tanto, foram utilizadas 20 cadelas e 129 filhotes distribuídos em quatro grupos. No grupo 1 (5 cadelas e 39 neonatos), a indução anestésica foi feita com propofol; no grupo 2 (5 cadelas e 25 neonatos), com etomidato; no grupo 3 (5 cadelas e 26 neonatos) com tiopental e no grupo 4, (5 cadelas e 39 neonatos) utilizou-se anestesia epidural e indução com halotano através de máscara. Em todos os casos, a medicação pré-anestésica foi feita com midazolam na dose de 0,22mg kg-1 via IM, e a manutenção anestésica com halotano em circuito semifechado e concentração inicial de 3V%. As variáveis avaliadas nas cadelas foram: temperatura retal, freqüência cardíaca, freqüência respiratória, saturação da oxi-hemoglobina (SpO2), pressão arterial média. Para a avaliação dos recém-nascidos, foram mensurados: freqüência cardíaca, esforço respiratório, movimentos musculares, coloração das mucosas e irritabilidade reflexa interpretados através do escore de Apgar modificado, bem como a SpO2 do neonato. Os resultados mostraram que todos os protocolos foram adequados para as mães com mínimos efeitos sistêmicos. Para o neonato, a utilização de anestesia epidural na mãe, seguida de indução e manutenção com halotano foi superior aos protocolos que usaram agentes injetáveis na indução anestésica.

          Translated abstract

          This work aimed at comparing the anaesthetic inductive effects among drugs such as propofol, etomidate and tiopental as well as the epidural anaesthesia with lidocaine following direct induction in bitches undergone caesarian section and their puppies. For so, 20 bitches and 129 puppies were used and distributed in four groups. group 1 (5 bitches and 39 puppies) the anaesthetic induction was made by using propofol, in group 2 (5 bitches and 25 puppies) by using etomidate, in group 3 (5 bitches and 26 puppies) tiopental and in group 4 (5 groups and 39 puppies) epidural anaesthesia and halothane induction through mask. In all cases, the pre-anaesthetic medication was midazolam in doses of 0.22mg kg-1 via IM, and the anaesthetic maintance with halothane in semi-closed circuit and initial concentration of 3V%. The variables evaluated in the bitches were: rectal temperature, heart rate, breath rate, oxi-hemoglobine saturation (SpO2), and mean blood pressure. For the puppies evaluation, it was measured: heart rate, breath effort, muscular movements, mucus color and reflex irritability and also the SpO2. They were interpreted through the modified Apgar score. The results showed that all the protocols were adequate for the mothers with minimum system effects. For the puppies, the epidure anaesthesia usage following the induction and halothane maintance was superior to the protocols that had used injectable agents in the anaesthetic induction.

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          Most cited references20

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          A proposal for a new method of evaluation of the newborn infant.

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              Anaesthesia for caesarean section (epidural and general): effects on the neonate.

              W Dick (1995)
              Anaesthesia may impair the condition of the neonate either directly (largely mechanically in utero or due to the influence of drugs) or indirectly via alteration of placental perfusion. These influences may further differ during normal caesarean section from those under complicated conditions. The criteria with which neonatal conditions are estimated need to be carefully distinguished with respect to results obtained. Neurobehavioural test results may give different information to the observer. A variety of drugs, not simply one, is used during general anaesthesia (GA). Even the consequences of maternal stress-fetal and neonatal levels of catecholamines or endogenous peptides may play a role. Local anaesthetics are known to cross the placenta as general anaesthetics do; in most cases, their effects are clinically irrelevant. Fetal and neonatal deliterious effects of regional anaesthesia (RA) are mainly related to maternal hypotension and the administration of large doses of local anaesthetics. If adequate doses of local anaesthetics and/or opioids are used, alterations in neurobehavioural scores are subtle and transient. Under normal maternal and fetal conditions, GA and RA are almost identically useful with respect to neonatal well being after caesarean section; subtle and inconsistent neurobehavioral residua may be present for a short period of time following GA. Under conditions of a compromised fetus, the neonate may however benefit from epidural anaesthesia more than from GA.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                cr
                Ciência Rural
                Cienc. Rural
                Universidade Federal de Santa Maria (Santa Maria )
                1678-4596
                December 2004
                : 34
                : 6
                : 1833-1839
                Affiliations
                [1 ] Universidade Federal de Viçosa Brazil
                Article
                S0103-84782004000600026
                10.1590/S0103-84782004000600026
                97873d30-b92e-4ed2-8f86-fd95822533cb

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-8478&lng=en
                Categories
                AGRONOMY

                Horticulture
                depressão fetal,cirurgia,fármacos indutores,surgery,inductive drugs,foetal depression
                Horticulture
                depressão fetal, cirurgia, fármacos indutores, surgery, inductive drugs, foetal depression

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