Disritmias cardíacas e anestesia

Lorentz, Michelle Nacur; Vianna, Bruna Silviano Brandão

doi:10.1590/s0034-70942011000600013

Cited by 9 publications

(5 citation statements)

References 38 publications

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“…A redução na FC observada ocorreu devido ao aumento do tônus vagal e resposta reflexa dos barorreceptores à vasoconstrição periférica transitória causada pela detomidina [18]. A ausência de diferença significativa a partir do início da infusão se deve à ação da dextrocetamina, a qual possui ação simpaticomimética e aumenta a frequência cardíaca [8].…”

Section: Discussionunclassified

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Continuous Intravenous Anesthesia by Dextroketamine and Detomidine in Bitches Subjected to Ovariohysterectomy and Premedicated with Midazolam and Morphine

Henrique¹,

Pereira²,

Medeiros³

et al. 2019

Acta Scientiae. Vet.

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Background:The use of injectable anesthetics to induce and maintain anesthesia has been the subject of extensive research. Ketamine induces dissociative anesthesia, which is characterized by sensory loss, analgesia and amnesia without loss of consciousness. The levorotatory isomer of ketamine is dextroketamine. Detomidine, a potent myorelaxant that acts as a sedative and analgesic, is commonly used on horses but rarely tested in dogs. The purpose of this study was to evaluate the cardiorespiratory and anesthetic effects promoted by a combination of detomidine and dextroketamine applied via continuous intravenous infusion in bitches premedicated with midazolam and morphine. Materials, Methods & Results:Eight bitches treated at the veterinary hospital of the Federal University of Campina Grande were referred for elective ovariohysterectomy (OHE). The animals were premedicated with 0.3 mg/kg of midazolam and 0.1 mg/kg of morphine intramuscular (IM) followed, after 15 min, with 0.02 mg/kg of detomidine IM. Fifteen min after the administration of detomidine, 3.5 mg/kg of dextroketamine was administered intravenously (IV), followed by continuous IV infusion of 14 mg/kg/h of dextroketamine and 30 μg/kg/h of detomidine. Heart rate (HR), respiratory rate (RR), body temperature (BT), mean arterial pressure (MAP), myorelaxation and electrocardiogram were recorded before and 15 min after the administration of midazolam and morphine (M0 and M1), 15 min after detomidine (M2), immediately after starting the infusion (M3), at 10 min intervals up to 60 min (M4, M5, M6, M7, M8 and M9) and 30 min after the end of the infusion (M10). Blood gas variables were analyzed at M0, M1, M2, M6, M9 and M10. Analgesia was evaluated by measuring cortisol and glucose levels at M0, three min after dermotomy, three min after clamping the ovarian pedicle, and three min after dermorrhaphy. The quality and duration of recovery were evaluated. HR dropped significantly from M2 to M4 (P < 0.05), with bradycardia recorded at M2; at RR, with bradypnea starting at M2; and at BT from M6 to M10 (P < 0.05), without severe hypothermia. Mean arterial pressure (MAP) increased significantly from M3 to M7 (P < 0.01). Hypotension was observed at M1. The following were also observed: high amplitude T wave, elevated ST segment, atrioventricular blocks, sinus arrest and premature ventricular complexes. The blood gas variables suggested the presence of respiratory acidosis with hypoxemia. Cortisol levels were significantly higher (P < 0.01) after clamping the ovarian pedicle (6.23 ± 3.07 μg/dL) and after dermorrhaphy (6.03 ± 2.24 μg/dL) than the levels at M0 (1.74 ± 1.08 μg/dL). Glucose levels three min after dermorrhaphy (129.46 ± 29.61 mg/dL) were substantially increased (P < 0.05) in comparison to M0 (89.66 ± 7.92 mg/dL). Myorelaxation was significantly higher from M3 to M9 (P < 0.05) than at M0 and M1. The recovery period lasted 302.1 ± 64.9 min. The quality of recovery was considered excellent in two animals, good in four animals and poor in two animals, which sho...

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Section: Discussionunclassified

“…O aumento na PAM se deve à vasoconstricção periférica promovida pela dextrocetamina [8]. A hipotensão em M1 ocorreu, provavelmente, devido ao midazolam que ocasiona ligeira redução da pressão arterial, consequente à diminuição da resistência vascular periférica [3].…”

Section: Discussionunclassified

Continuous Intravenous Anesthesia by Dextroketamine and Detomidine in Bitches Subjected to Ovariohysterectomy and Premedicated with Midazolam and Morphine

Henrique¹,

Pereira²,

Medeiros³

et al. 2019

Acta Scientiae. Vet.

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“…When ischemic myocardial pathology is suspected, the dose of atropine should be carefully titrated to avoid extending the ischemic area. 25,26…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest during laparoscopic cholecystectomy☆

Sabogal

Vivas

2013

Colombian Journal of Anesthesiology

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Objective: To undertake a literature review on third-degree complete atrioventricular block in laparoscopic cholecystectomy, describing its incidence, etiology and management update.Materials and methods: This is a case discussion of a patient with cardiac arrest following complete wide-complex heart block during a laparoscopic cholecystectomy, its management, and outcomes. The literature search included PubMed, Scielo and Bireme.Results: Complete or third degree paroxysmal AV block is a rare occurrence that may be triggered by surgical vagal stimuli (surgical stress, pneumoperitoneum) and by non-surgical stimuli (carotid massage, coughing, exercise, vomiting and swallowing), in addition to stimuli from myocardial ischemia and cardiac conduction anomalies. This is the first case in our institution but there are very few cases described in the world literature and none at the national level.Conclusions: Enhanced knowledge and experience of the anesthesiologist is required for the diagnosis and management of complete heart block in laparoscopic cholecystectomy, which is the most frequent laparoscopic surgical procedure worldwide. The use of epidural anesthesia associated with general anesthesia for upper abdominal and chest surgery reduces by five fold the occurrence of postoperative cardiac arrhythmia. Three safety measures are recommended for ASA 3 and 4 patients with cardiovascular comorbidity: consider invasive blood pressure monitoring, head at 10 • and limit the pneumoperitoneal pressure to 7 mmHg.

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“…iMg is also vital for the intracellular regulation and transport of Na, K, and iCa [ 12 ]. So, rapid serial measurement of iMg is crucial for the management of electrolyte deficiencies [ 29 ]. Hypomagnesaemia and hypocalcemia are very common (up to 40%) in patients with other electrolyte abnormalities [ 30 ], demonstrating that iMg, Na, K, and Ca should always be tested together for proper electrolyte near-normal.…”

Section: Ionized Vs Total Magnesium Levels In Intensive Care Patientsmentioning

confidence: 99%

Ionized or Total Magnesium levels, what should we measure in critical ill patients?

Scarpati¹,

Baldassarre²,

Oliva³

et al. 2021

Translational Medicine @ UniSa

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Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.

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Disritmias cardíacas e anestesia

Cited by 9 publications

References 38 publications

Continuous Intravenous Anesthesia by Dextroketamine and Detomidine in Bitches Subjected to Ovariohysterectomy and Premedicated with Midazolam and Morphine

Continuous Intravenous Anesthesia by Dextroketamine and Detomidine in Bitches Subjected to Ovariohysterectomy and Premedicated with Midazolam and Morphine

Cardiac arrest during laparoscopic cholecystectomy☆

Ionized or Total Magnesium levels, what should we measure in critical ill patients?

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