Conduta anestésica em cão submetido a toracoscopia para biópsia de neoplasia em base de coração - relato de caso

Abstract

The objective of this study is to report the anesthetic management in a thoracic surgery performed by videosurgery. Dog, male, French Bulldog breed, 9 years old, 14.7 kg was referred for heart biopsy. In the preoperative exams, neoformation in the cardiac base and pericardial effusion were detected, without cardiac tamponade, globular cardiac silhouette, displacement of the tracheal path and bronchointerstitial pulmonary pattern, and pure transudate was drained after abdominal ultrasonography. It received 0.3 mg/kg of methadone (IM) and 3 mg/kg of tiletamine/zolazepam (IM) as premedication, being induced to general anesthesia with propofol 1 mg/kg (IV), midazolam 0.3 mg/kg (IV) and etomidate 0.5 mg/kg (IV). For intraoperative analgesia, intercostal blockade with bupivacaine was performed, administering 0.35 mL/point, bilaterally in the 6th, 7th and 8th intercostal space (ICE), in addition to continuous infusion of remifentanil at a rate of 10 mcg /kg/h (IV), ketamine 1 mg/kg/h (IV) and lidocaine 2 mg/kg/h (IV). For anesthetic maintenance, intravenous partial anesthesia with propofol and isoflurane was chosen. HR, ƒ, SpO2, ETCO2, esophageal temperature, electrocardiogram and SBP, MAP and DBP were monitored using the non-invasive method. It had hypercapnia and respiratory acidosis, which were partially corrected during the anesthetic period and in the immediate postoperative period. From the difficulty in maintaining SpO2, the application of general anesthetic drugs, opiates, pneumothorax and airway obstruction is supposed to be the cause. Histopathological examination revealed aortic and thymus body tumor with branchial cysts. It was concluded that multimodal analgesia and anesthetic monitoring were adequate and based on the patient's complementary exams, a safe and satisfactory anesthesia was obtained.