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Impacto do bloqueio intratesticular durante a orquiectomia na redução da dor pós-operatória em cães
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Resumo(s)
A International Association for the Study of Pain, define dor como uma “experiência sensorial e emocional desagradável associada a uma lesão tecidular potencial ou real”. Reconhecer os sinais de dor em cães é um fenómeno complexo, de forma a garantir o tratamento adequado, evitando os malefícios fisiopatológicos consequentes da dor e promovendo o bem-estar animal. Em Medicina Veterinária, no reconhecimento e avaliação da dor, são, frequentemente, utilizadas escalas, como ferramenta prática e facilmente acessível que permite pontuar as alterações comportamentais manifestadas pelos animais. O objetivo da elaboração desta dissertação reside na avaliação do impacto da realização do bloqueio intratesticular com lidocaína na diminuição da manifestação de dor, no período pós operatório imediato, em cães submetidos a orquiectomia eletiva. Numa amostra de 7 canídeos (n=7) do sexo masculino, 42,86% dos animais foram submetidos a bloqueio intratesticular com soro fisiológico (NaCl) a 0,9% (G0) e 57,14% ao mesmo bloqueio com lidocaína 20 mg/ml (G1). No período pós-operatório imediato, foram realizadas cinco avaliações da dor, P1, P2, P3, P4, P5 com recurso à Versão Curta da Escala de dor Composta de Glasgow (CMPS-SF), com intervalo de trinta minutos entre cada avaliação. Os resultados obtidos, analisados a partir do teste não paramétrico de Mann-Whitney U, forneceram fortes evidências de que há, uma diferença estatística significativa, entre os grupos G0 e G1. O valor obtido de p = 0,041 sugere que, a diferença observada para as pontuações de dor entre grupos, não é uma ocorrência aleatória, mas sim uma consequência da administração do anestésico local. No presente estudo, a amostra reduzida compromete a validade dos resultados para além da subjetividade associada à ferramenta utilizada, CMPS-SF. Ainda assim, a CMPS-SF é a escala com maior validação, entre as demais e a, atualmente, recomendada pelas diretrizes, para o efeito. Assim, foi possível concluir que, a administração de lidocaína reduz significativamente as pontuações de dor no grupo de animais com o respetivo bloqueio intratesticular, face aqueles com bloqueio intratesticular com solução salina isotónica
The International Association for the Study of Pain defines pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Recognising the signs of pain in dogs is a complex phenomenon, in order to ensure appropriate treatment, avoiding the pathophysiological harm resulting from pain and promoting animal welfare. In Veterinary Medicine, pain scales are often used as a practical and easily accessible tool for scoring behavioural changes in animals. The objective of this dissertation is to evaluate the impact of intratesticular blockade with lidocaine on the reduction of pain on the immediate postoperative period in dogs submitted to elective orchiectomy. In a sample of seven male dogs (n=7), 42,86% of the animals underwent intratesticular block with 0,9% saline solution (NaCl) (G0) and 57,14% underwent the same block with lidocaine 20 mg/ml (G1). In the immediate postoperative period, five pain assessments were performed, P1, P2, P3, P4, P5 using the short version of the Glasgow Composite Pain Scale (CMPS SF), with a thirty-minute interval between each assessment. The results obtained, analysed using the non-parametric Mann-Whitney U test, provided strong evidence that there is a statistically significant difference between groups G0 and G1. The value obtained of p = 0,041 suggests that the difference observed for pain scores between groups is not a random occurrence, but rather a consequence of the administration of the local anaesthetic. In the present study, the small sample size compromises the validity of the results, in addition to the subjectivity associated with the tool used, CMPS-SF. Nevertheless, the CMPS-SF is the most validated scale among the others and is, currently, recommended by the guidelines for this purpose. Thus, it was possible to conclude that, the administration of lidocaine significantly reduces pain scores in the group of animals with intratesticular blockage, compared to those with intratesticular blockage with isotonic saline solution
The International Association for the Study of Pain defines pain as an “unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Recognising the signs of pain in dogs is a complex phenomenon, in order to ensure appropriate treatment, avoiding the pathophysiological harm resulting from pain and promoting animal welfare. In Veterinary Medicine, pain scales are often used as a practical and easily accessible tool for scoring behavioural changes in animals. The objective of this dissertation is to evaluate the impact of intratesticular blockade with lidocaine on the reduction of pain on the immediate postoperative period in dogs submitted to elective orchiectomy. In a sample of seven male dogs (n=7), 42,86% of the animals underwent intratesticular block with 0,9% saline solution (NaCl) (G0) and 57,14% underwent the same block with lidocaine 20 mg/ml (G1). In the immediate postoperative period, five pain assessments were performed, P1, P2, P3, P4, P5 using the short version of the Glasgow Composite Pain Scale (CMPS SF), with a thirty-minute interval between each assessment. The results obtained, analysed using the non-parametric Mann-Whitney U test, provided strong evidence that there is a statistically significant difference between groups G0 and G1. The value obtained of p = 0,041 suggests that the difference observed for pain scores between groups is not a random occurrence, but rather a consequence of the administration of the local anaesthetic. In the present study, the small sample size compromises the validity of the results, in addition to the subjectivity associated with the tool used, CMPS-SF. Nevertheless, the CMPS-SF is the most validated scale among the others and is, currently, recommended by the guidelines for this purpose. Thus, it was possible to conclude that, the administration of lidocaine significantly reduces pain scores in the group of animals with intratesticular blockage, compared to those with intratesticular blockage with isotonic saline solution
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Orquiectomia Escala de dor Lidocaína Bloqueio anestésico Cães Orchiectomy Pain scale Lidocaine Anesthetic block Dogs