efeito da dexmedetomidina sobre a arritmia cardíaca induzida pela adrenalina em cães anestesiados pelo sevofluorano effect of dexmedetomidine on the heart arrhythmia induced by the adrenaline in dogs anesthetized by sevoflurane

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ID: 187670
2007
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Abstract
Avaliou-se o efeito da dexmedetomidina sobre o ritmo cardíaco em 20 cães, sem raça definida, de ambos os sexos e considerados sadios, anestesiados pelo sevofluorano e submetidos a doses crescentes de adrenalina. Os animais foram, aleatoriamente, distribuídos em dois grupos (placebo e dexmedetomidina). No grupo placebo, os animais receberam, por via intravenosa, solução de NaCl a 0,9%, na dose de 0,3ml/kg. Foram considerados dois momentos, M0 e M1, imediatamente antes e após a aplicação, respectivamente. Após 10 minutos, realizou-se a indução anestésica com sevofluorano, por meio de máscara facial vedada, até a perda do reflexo laringotraqueal. Em seguida, procedeu-se à intubação orotraqueal e a manutenção da anestesia foi realizada com a administração de sevofluorano na concentração de 1,5CAM, em circuito anestésico com reinalação parcial de gases. Decorridos 20 minutos da indução anestésica, iniciou-se a administração intravenosa contínua de solução de adrenalina a 2% em doses crescentes de 1, 2, 3, 4 e 5mg/kg/min, por meio de bomba de infusão, com aumento da dose em intervalos de 10 minutos. Imediatamente antes desse acréscimo eram feitas as mensurações (M2 a M6). No grupo dexmedetomidina empregou-se a mesma metodologia substituindo-se a solução de NaCl a 0,9% por hidrocloridrato de dexmedetomidina, na dose de 1µg/kg. Foram registradas as pressões arteriais, em M0 e em M2 a M6, e o traçado eletrocardiográfico, na derivação DII (M2 a M6), considerando-se para efeito estatístico o número total de bloqueios atrioventriculares (BAV) de primeiro e segundo graus e de complexos ventriculares prematuros (ESV), coincidentes com cada dose de adrenalina. Os dados foram submetidos à análise de variância seguida pelo teste de Tukey (P<0,05). Verificou-se que a dexmedetomidina interfere significativamente na condução atrioventricular levando a maior ocorrência de BAV e reduz o número de ESV nas doses infundidas de 2 e 3mg/kg/min de adrenalina. Logo após a aplicação de dexmedetomidina, observaram-se redução da freqüência cardíaca e da pressão arterial, cuja diminuição persistiu por até uma hora.
The effect of dexmedetomidine on the cardiac rhythm in twenty healthy mongrel dogs of both sexes anesthetized with sevofluorane and submitted to increasing doses of adrenaline was evaluated. The animals were randomly allotted to different treatment groups. Animals of placebo group were intravenous injected with 0.9% NaCl solution at 0.3ml/kg/IV. Two moments were considered, M0 and M1, the moments immediately before and after application, respectively. Ten minutes later, the dogs were anesthetized using sevofluorane via face mask until lost of their laringotracheal reflex. Then, orotracheal intubation was performed and maintenance of anesthesia was kept with 1,5MAC sevofluorane using an anesthetic circuit with a rebreathing system. Twenty minutes after anesthesia induction, continuous IV administration of 2% adrenaline solution was given at increasing doses of 1,2,3,4 and 5mg/kg/min., every ten minutes, respectively. The moments M2 to M6 were measured immediately before the next increase of dose. In dexmedetomidine group, the same technique was used replacing 0.9% NaCl by dexmedetomidine hydrochloride at 1mg/kg. Blood pressures were recorded at M0 and M2 to M6. Electrocardiography line in the derivation DII (M2 to M6) was used to observe the number of atrioventricular blocks (AVB) of first and second degrees and ventricular premature complexes (VPC). Statistic evaluation was performed by analysis of variance followed by Tukey's test (P<0.05). Dexmedetomidine significantly altered the atrioventricular conduction resulting in a higher occurrence of AVB. This drug reduced the number of VPC at 2 and 3mg/kg/min of adrenaline. After administration of dexmedetomidine, reduction of arterial blood pressure up to one hour and reduction of cardiac rate were observed.
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Authors V.F. Barbosa, N. Nunes, E.d.v. Conceição, C.T. Nishimori, D.P. Paula, P.C. Ferro, R. Carareto
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Journal Environmental research
Year 2007
DOI
10.1590/S0102-09352007000600014
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-09352007000600014
Keywords
dog

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