Impacto da anestesia peridural sacrococcígea e lombo-sacra com levobupivacaína na analgesia perioperatória de gatas submetidas à ovariosalpingohisterectomia

Abstract

The aim of this study was to compare the perioperative analgesic efficacy of sacrococcygeal with lumbosacral epidural anesthesia in cats undergoing ovariohysterectomy. In a prospective, randomized, controlled-blinded study, 36 cats undergoing elective OSH were evaluated. The animals were sedated intramuscularly with acepromazine (0.05 mg/kg) plus meperidine (6 mg/kg). Anesthesia was induced with propofol (dose-effect) and maintained with isoflurane/O2. After the establishment of general anesthesia, the cats were assigned into three treatments (n = 12 per group), which consisted of sacrococcygeal (GSC) or lumbosacral (GLS) epidural administration of levobupivacaine 0.5% (1 mg/kg) and no treatment with epidural (control) (GC). During anesthesia, heart rate, noninvasive systolic arterial pressure, respiratory variables and end-tidal isoflurane concentration (FE´ISO) were monitored. Intraoperatively, fentanyl was given to control cardiovascular responses to surgical stimulation. Sedation and pain were assessed preoperatively and at various time points up to 8 hours after extubation. Morphine (0.2 mg/kg, IM) was administered as rescue analgesia. Data were analyzed using the chi-square test, Tukey test, Kruskal–Wallis test and Friedman test (p < 0.05). Intraoperatively, overall FE´ISO and analgesic supplementation requirements were lower in the GLS and GSC compared to the GC (p = 0.006 - 0.048). Cardiorespiratory variables, pain and sedative scores did not differ among groups. Postoperative rescue analgesia was required in 50%, 41.6% and 50% of the cats of GSC, GLS and GC, respectively (p = 0.22). As part of a balanced anesthesia protocol, sacrococcygeal was as effective as lumbosacral epidural anesthesia to decrease intraoperative anesthetic and analgesic requirements. However, neither sacrococcygeal nor lumbosacral epidural anesthesia provided significant postoperative analgesic benefits compared with the control treatment.