scholarly journals Anestesia em Jacaré-americano (Alligator mississipiensis) para Amputação de Membro

2017 ◽  
Vol 45 ◽  
pp. 5
Author(s):  
Rochelle Gorczak ◽  
Rafael Oliveira Chaves ◽  
Marcella Linhares Teixeira ◽  
Ítalo Barros De Freitas ◽  
Raimy Costa Martins ◽  
...  

Background: The knowledge of secure anesthetic protocols for reptiles is very important, especially because they are aggressive species and they have peculiar physiology, unpredictable reactions to the same drug in different environmental conditions and different physiological responses can be observed. The anesthetic protocol aims immobilization, analgesia and muscle relaxation for adequate, safe and easily reversible anesthesia. Few reports have been described on anesthesia in animals and, before that, the objective of this study is to report the anesthetic protocol that was used and vital parameters monitoring in an Alligator mississipiensis that was submitted to surgery for limb amputation.Case: A female American alligator was attended, with about 8-year-old, 2 m long and 268,964 pounds, with fight history with other animal six months ago, resulting in a wound in the right toracic limb. When the lesion occurred, it was the breeding season of the species, so we chose not to perform the treatment at that time. An X-ray of the member was performed, which showed, among other changes, osteomyelitis and septic arthritis. Thus, the limb amputation was indicated. Ketamine association (10 mg/kg) and medetomidine (0.1 mg/kg) were used as anestesic premedication, both administered intramuscularly. For anesthetic induction, propofol (4 mg/kg) intravenously was used. The animal was intubated using an endotracheal tube number 11 without inflating the cuffing, and for the maintenance it was employed isoflurane. The heart rate was measured using Doppler and the respiratory rate by visual and balloon observation in the oxygen circular system. The other parameters were measured using a multiparameter monitor sensor connected to the tongue. The local anesthetic block was made close to the incision line, the medium third humerus with 2 mg/kg of 2% lidocaine without vasoconstrictor, diluted in 0.9% NaCl until the volume of 10 mL is completed to assist in analgesia. The parameters recorded during the procedure, which lasted 80 min, remained within the normal pattern of species (three breaths per minute, 30 heart beats per min and 80.6°F temperature). After surgery meloxicam (0.2 mg/kg) and atipamezole reverser (0.5 mg/kg) were administered, both intramuscularly. The animal took about seven hours to fully return from anesthesia.Discussion: Different anesthetics protocols may be employed to crocodilians using both local anesthetic techniques and general, in order to promote analgesia, muscle relaxation and adequate anesthesia. Still, it is very important to monitor the patient during the procedure, in order to be a different physiology kind of species. Cardiac auscultation is quite difficult in these animals, so it is recommended to use non-invasive electronic equipment as the Doppler, the multiparameter monitor, the pulse oximeter and esophageal stethoscope for assistance in monitoring heart and respiratory rate, providing important trans-operative information. The realization of amputations in crocodilians is common, however there are few reports in the literature about their anesthesia, this way, this article has a significant contribution to a better anesthetic protocol clarification to be used in these animals. Therefore, it is concluded that the anesthetic protocol based on premedication with ketamine and medetomindina, propofol induction and maintenance with isoflurane, besides local anesthesia with lidocaine was effective and safe for thoracic limb amputation surgery in an American alligator.

2019 ◽  
Vol 24 (4) ◽  
Author(s):  
Anna Kołakowska ◽  
Anna Pigan

The article is based on the analysis of the literature and the latest international guidelines of dental associations in order to systematize the knowledge of doctors. The paper discusses local anesthetic agents such as lignocaine, benzocaine, articaine or mepivacaine, many times used in daily practice by dentists. Various anesthetic techniques, including computer-controlled systems for administering anesthesia, are described in the publication. The topic of teething preparations containing anesthetics and the risks associated with their use were also discussed, so that dentists could warn against their use of carers and parents of children and thus reduce the number of complications after their use. Contraindications to the use of analgesia have been presented and the complications that may occur after their administration have been characterized, thanks to which the right choice of the appropriate agent for analgesia will reduce the risk of possible complications after local anesthesia. The authors hope that after reading the article, doctors will be confident in using the benefits of local anesthetics.


2020 ◽  
Vol 10 (3) ◽  
pp. 1050
Author(s):  
Olga Drewnowska ◽  
Bernard Turek ◽  
Barbara Lisowska ◽  
Charles E. Short

Management of equine anesthesia monitoring is still a challenge. Careful monitoring to provide guidelines for anesthesia depth assessment currently relies upon eye signs, cardiopulmonary responses, and the level of muscle relaxation. Electroencephalography, as a non-invasive brain activity monitor, may be used to complement the routinely monitored physiologic parameters. Six horses, undergoing various surgical procedures and anesthesia protocols, were monitored with the use of a Root with Sedline EEG monitor and a routine monitor of life parameters. The life parameters were compared to the changes on the EEG density spectral array observed live during anesthesia. During all procedures the level of awareness was monitored using the EEG, with higher frequency and power of waves indicating a higher level of awareness. It was evident from this that there were variations according to the type of procedure and the anesthetic protocol. Cerebral activity was elevated during painful moments of the surgery and recovery, requiring adjustments in anesthetic concentrations. Evaluation of changes in the spectral edge frequency (SEF) could show the periods when the patient is stabilized. EEG monitoring has the potential to be used in clinical anesthesiology of horses. It was shown that this system may be used in horses under general anesthesia but is currently less effective in a standing horse for diagnostic or minor procedures.


2021 ◽  
Vol 5 ◽  
pp. 93
Author(s):  
Jesse Coleman ◽  
Amy Sarah Ginsburg ◽  
William M. Macharia ◽  
Roseline Ochieng ◽  
Guohai Zhou ◽  
...  

Background: Heart rate (HR) and respiratory rate (RR) can be challenging to measure accurately and reliably in neonates. The introduction of innovative, non-invasive measurement technologies suitable for resource-constrained settings is limited by the lack of appropriate clinical thresholds for accuracy comparison studies. Methods: We collected measurements of photoplethysmography-recorded HR and capnography-recorded exhaled carbon dioxide across multiple 60-second epochs (observations) in enrolled neonates admitted to the neonatal care unit at Aga Khan University Hospital in Nairobi, Kenya. Trained study nurses manually recorded HR, and the study team manually counted individual breaths from capnograms. For comparison, HR and RR also were measured using an automated signal detection algorithm. Clinical measurements were analyzed for repeatability. Results: A total of 297 epochs across 35 neonates were recorded. Manual HR showed a bias of -2.4 (-1.8%) and a spread between the 95% limits of agreement (LOA) of 40.3 (29.6%) compared to the algorithm-derived median HR. Manual RR showed a bias of -3.2 (-6.6%) and a spread between the 95% LOA of 17.9 (37.3%) compared to the algorithm-derived median RR, and a bias of -0.5 (1.1%) and a spread between the 95% LOA of 4.4 (9.1%) compared to the algorithm-derived RR count. Manual HR and RR showed repeatability of 0.6 (interquartile range (IQR) 0.5-0.7), and 0.7 (IQR 0.5-0.8), respectively. Conclusions: Appropriate clinical thresholds should be selected a priori when performing accuracy comparisons for HR and RR. Automated measurement technologies typically use median values rather than counts, which significantly impacts accuracy. A wider spread between the LOA, as much as 30%, should be considered to account for the observed physiological nuances and within- and between-neonate variability and different averaging methods. Wider adoption of thresholds by data standards organizations and technology developers and manufacturers will increase the robustness of clinical comparison studies.


2018 ◽  
Vol 75 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Sasa Hinic ◽  
Jelena Saric ◽  
Predrag Milojevic ◽  
Jelena Gavrilovic ◽  
Tijana Durmic ◽  
...  

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.


2021 ◽  
Vol 12 (2) ◽  
pp. 712-716
Author(s):  
Edsel Ing ◽  
Felix Tyndel ◽  
Joyce Tang ◽  
Thomas R. Marotta

A 67-year-old woman had delayed initial diagnosis of her right low flow carotid cavernous fistula (CCF) during the coronavirus disease (COVID-19) pandemic due to difficulty detecting ocular signs via online virtual examinations. Her right eye conjunctival erythema and proptosis with medial rectus enlargement on computed tomography scan was initially misdiagnosed as euthyroid thyroid-associated orbitopathy without lid retraction. She developed vision loss, and increasing episcleral venous congestion and CCF was suspected. Computed tomographic angiography did not show an obvious fistula. Digital subtraction angiography revealed the right-sided low flow CCF, which was fed from vessels from the contralateral side.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0256115
Author(s):  
Carlijn Lempersz ◽  
Lore Noben ◽  
Sally-Ann B. Clur ◽  
Edwin van den Heuvel ◽  
Zhouzhao Zhan ◽  
...  

Introduction A fetal anomaly scan in mid-pregnancy is performed, to check for the presence of congenital anomalies, including congenital heart disease (CHD). Unfortunately, 40% of CHD is still missed. The combined use of ultrasound and electrocardiography might boost detection rates. The electrical heart axis is one of the characteristics which can be deduced from an electrocardiogram (ECG). The aim of this study was to determine reference values for the electrical heart axis in healthy fetuses around 20 weeks of gestation. Material and methods Non-invasive fetal electrocardiography was performed subsequent to the fetal anomaly scan in pregnant women carrying a healthy singleton fetus between 18 and 24 weeks of gestation. Eight adhesive electrodes were applied on the maternal abdomen including one ground and one reference electrode, yielding six channels of bipolar electrophysiological measurements. After removal of interferences, a fetal vectorcardiogram was calculated and then corrected for fetal orientation. The orientation of the electrical heart axis was determined from this normalized fetal vectorcardiogram. Descriptive statistics were used on normalized cartesian coordinates to determine the average electrical heart axis in the frontal plane. Furthermore, 90% prediction intervals (PI) for abnormality were calculated. Results Of the 328 fetal ECGs performed, 281 were included in the analysis. The average electrical heart axis in the frontal plane was determined at 122.7° (90% PI: -25.6°; 270.9°). Discussion The average electrical heart axis of healthy fetuses around mid-gestation is oriented to the right, which is, due to the unique fetal circulation, in line with muscle distribution in the fetal heart.


2020 ◽  
Vol 16 (2) ◽  
pp. 86-91
Author(s):  
Md Harisul Hoque ◽  
SM Mustafa Zaman ◽  
Khurshid Ahmed ◽  
Sajal Krisna Banerjee ◽  
Md Faisal Ibne Kabir ◽  
...  

Pulmonary hypertension is a hemodynamic disorder defined by abnormally high pulmonary artery pressure that affects the arteries in your lungs and the right side of your heart. In this study, hepatic venous duplex will be done to diagnose and quantify the PH. So that Patients can avoid unnecessary invasive right heart catheterization. This practical demonstration is the key to enrich our experience and knowledge in the field of PH. Objectives of this study was to assess PH status by Hepatic venous Duplex (HVD) as well by right heart catheterization and to compare them. This study was conducted in the Department of Cardiology, BSMMU, Shahbagh, Dhaka extending from July 2018 to December 2019. Total 100 (One hundred) subjects were enrolled in this study. It was an Observational study and includes the subjects between 18 years to 45 years of age. Results of this study shows very close proximity to that of Right heart catheterization. Hemodynamic changes in Hepatic venous duplex study could be used as an alternative diagnostic tool for evaluating moderate to severe pulmonary hypertension. This method could counteract the weakness of the currently used diagnostic methods and improve the accuracy of assessing pulmonary hypertension when combined with other methods. University Heart Journal Vol. 16, No. 2, Jul 2020; 86-91


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Eric Sung ◽  
Adityo Prakosa ◽  
Natalia Trayanova

Introduction: Post-infarct ventricular tachycardias (VT) arise due to structural remodeling (scarring). Physiological repolarization gradients (apicobasal and transmural) exist in the human heart, but the effects on post-infarct VT dynamics are unknown. Hypothesis: We hypothesized that incorporation of repolarization gradients in personalized digital hearts of post-infarct patients impacts VT exit sites without altering the location of the VTs. Methods: 3D late-gadolinium enhanced CMR images were acquired from 7 post-infarct patients. Personalized image-based computational heart models (digital hearts) representing scar and infarct border zone distributions were constructed. Apicobasal (AB) and transmural (TM) repolarization gradients were incorporated using a validated method (Fig A). VTs were induced at baseline (no repolarization gradient) via rapid pacing in the right ventricular apex, using two pacing cycle lengths, mimicking non-invasive programmed stimulation. Pacing protocols that induced baseline VTs were repeated under AB and TM conditions. Results: Ten VTs were induced in baseline digital hearts. 8 AB VTs and 8 TM VTs were induced; the remaining 2 VTs for both AB and TM digital hearts could not be induced. 5/8 induced AB VTs had VT exit sites matching baseline VT exit sites; the remaining 3/8 AB VTs had reversed VT exit and entrance sites from the corresponding baseline VTs (Fig B, VT 1 & 2). 4/8 induced TM VTs had exit sites that matched those at baseline; the remaining TM VTs had exit and entrance sites reversed from those of baseline VTs (Fig B, VT 1, 2 & 3). All 8 AB VTs and 8 TM VTs had the same location as corresponding baseline VTs. Conclusion: AB and TM repolarization gradients can act to reverse VT entrance and exit sites without changing VT location. Thus, incorporation of physiological repolarization gradients into personalized digital hearts may not impact VT ablation targeting but may affect accurate prediction of VT exit or entrance sites.


Sign in / Sign up

Export Citation Format

Share Document