Evaluación clínica sobre la infusión anestésica flk (fentanilo, lidocaína, ketamina) para el manejo del dolor intraoperatorio en caninos.

Abstract

Anesthesiology is understood as one more branch of Veterinary Sciences which is responsible for allowing the performance of surgical processes or treatments that can be painful or annoying and that in some way would be impossible to perform them with the patient in a conscious state, through the fulfillment of 3 fundamental pillars such as: hypnosis, muscle relaxation, analgesia and currently manages the protection of the central nervous system. Pain is described as an unpleasant sensory experience resulting from tissue damage, in animals, it is related to the mechanisms of transduction, transmission, modulation and perception of such harmful stimuli, similar to those already described in humans, continuous anesthetic infusions are one of the tools used, infusions based on morphine, lidocaine and ketamine (MLK), or fentanyl, ketamine and lidocaine (FLK), at analgesic doses have allowed not only to grant adequate analgesia to the surgical process performed, but also in the reduction of the anesthesia required for the patient, subjecting his body to less stress and facilitating his recovery, hence the importance and general objective of this research was to evaluate the effect of the anesthetic infusion of fentanyl, lidocaine and ketamine on the physiological constants related to intraoperative pain in canines. This was a prospective, non-experimental, observational, comparative research, where the effect of an anesthetic FLK infusion on the physiological constants related to intraoperative pain was evaluated, through monitoring and recording of variables such as: heart rate, respiratory rate, mean arterial pressure, temperature and oxygen saturation. The sample consisted of 15 female canine patients, between 6 months and 8 years of age, without weight or race restriction and with an anesthetic risk ASA I or ASA II, subjected to elective ovariohysterectomy and who were treated at the UTMACH veterinary clinic, who underwent the respective clinical history, physical examination and blood counts as part of the preoperative protocol. On the day of the surgery, the patients should have completed 6 hours of fasting, in addition to having a shirt, blanket and necklace. The 15 patients were divided into 3 groups with different intrachirugic analgesia protocols: Fentanyl boluses at regular intervals; infusion of fentanyl, lidocaine and ketamine; infusion of ketamine (0.6mg/kg/h) and lidocaine (1mg/kg/h). Data were recorded of the constants to be studied before the surgical procedure, and at the beginning with the analgesic therapy administered, data were recorded manually in a registry with intervals of 5 minutes, the data obtained were analyzed using the statistical program IMB SPSS version 21, the statistical test performed was ANOVA of a factor looking for significant differences between the study groups, in addition to the Duncan statistical test in those groups whose Sig. value was less than or equal to 0.05, thus rejecting the hypothesis of equality of means. The results obtained showed that there were significant differences between the means of each variable compared to the three groups of anesthetic protocol; patients who were administered fentanyl at regular intervals obtained a decrease in respiratory activity, along with temperature, while patients who were given the FLK infusion showed a normal distribution of physiological constants in relation to the first group, as did patients who received the infusion of ketamine plus lidocaine, with the particularity that this group presented values higher than those obtained in the FLK group, but did not present clinical relevance during surgery. In conclusion, the FLK anesthetic infusion did not present alterations that decreased the activity of the cardiovascular and respiratory system, maintaining stable values with a good therapeutic margin for the management of intraoperative pain in canine female patients undergoing ovariohysterectomy by medial approach.