Abstract
Abstract The present study aimed to evaluate the use of tumescent local anesthesia or epidural anesthesia associated with an intercostal nerve block in bitches submitted to mastectomy. Fourteen bitches from the clinical routine of the Veterinary Hospital of the Federal University of Pelotas were premedicated with acepromazine (0.03 mg/kg) and morphine (0.3 mg/kg) intramuscularly, then induced with propofol (2 to 6 mg/kg/IV) and maintained with 1,4V% isoflurane (calibrated vaporizer). The patients were randomly allocated into: GALT Group (n=7), which received tumescent local anesthesia (0.16%) at the dose of 15 mL/kg, and the GEBI Group (n=7) which received epidural anesthesia with lidocaine (5 mg/kg) and morphine (0.1 mg/kg) associated with an intercostal nerve block from the 6th to 12th intercostal space with lidocaine (2 mg/kg). An increase higher than 10% in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were considered as possible signs of nociception, to which fentanyl was administered intravenously as rescue analgesia. Postoperative analgesia was evaluated by means of the modified Glasgow scale at 30, 60, 120, 240 and 360 minutes. There were no differences in physiological parameters (0>0.05) in the transoperative period intra-group and inter-group the groups. The GEBI Group required more frequent transoperative rescue analgesia (9) in comparison to the GALT Group (5), but with no statistical difference. During the postoperative period, there was no need for rescue analgesia in either group. Results suggest that epidural anesthesia associated with intercostal nerve block can be used as an alternative technique in patients with restrictions against the use of local tumescent anesthesia.
Highlights
Mammary tumors are the most common neoplasms in female dogs, and the recommended treatment in these cases is surgical resection
The GEBI group showed 0% in IP, 28,30% in DMI, 14.30% DMT, 0% in PES, 57.20% in REM, and 28.30% in DER; there were no significant differences between the groups
In the GALT group, there was a significant difference between the baseline moment and the T0 and T1 times, and in the GEBI group, there was a significant difference between the baseline moment and T0 and T1 times (Table 2)
Summary
Mammary tumors are the most common neoplasms in female dogs, and the recommended treatment in these cases is surgical resection. Opioids are widely used in acute pain control; studies in humans report that opioids cause negative impacts on the immune system, such as immunosuppression and inhibition of the action of natural killer cells[4], thereby questioning their use in cancer patients. In this context, recent studies suggest that local anesthetics can enable a significant decrease in the use of opioids and other immunosuppressive drugs, contributing to better prognosis
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