Constant rate infusion of remifentanil in a cardiac patient for Perineal Hernia repair

Authors

DOI:

https://doi.org/10.31533/pubvet.v17n13e1514

Keywords:

Dog, cardiac disease, constant rate infusion, remifentanil

Abstract

Remifentanil is a very short-acting µ-opioid analgesic. In human medicine, remifentanil has been widely used for sedation and anesthesia in patients with critical cardiac conditions. In dogs, previous studies have shown that remifentanil significantly reduces cardiac index accompanied by bradycardia in dogs anesthetized with inhalational anesthetics. Thus, we have an improvement in anesthetic recovery and cardiovascular stability when administered in continuous infusion. This report aims to show the effects of continuous infusion of remifentanil in a heart disease patient seen at a private veterinary clinic undergoing surgery to correct a perineal hernia. During the procedure, the animal showed little response to the pain stimulus during anesthesia, but presented bradycardia and hypotension, which were responsive to atropine and noradrenaline, maintaining the animal at adequate pressure and heart rate throughout the procedure. It is concluded that the use of remifentanil in low doses in heart disease patients works as an adjuvant in pain control, providing the patient with a quick recovery after the procedure.

References

Akashi, N., Murahata, Y., Hosokawa, M., Hikasa, Y., Okamoto, Y., & Imagawa, T. (2021). Cardiovascular and renal effects of constant rate infusions of remifentanil, dexmedetomidine and their combination in dogs anesthetized with sevoflurane. Journal of Veterinary Medical Science, 83(2), 285–296. https://doi.org/10.1292/jvms.20-0457.

Almeida, C. O. S. (2021). Degeneração mixomatosa de valva mitral em cães: Revisão. PUBVET, 15(7), 1–10. https://doi.org/10.31533/pubvet.v15n07a863.1-10.

Beier, S. L., Mattoso, C. R. S., Aguiar, A. J. A., Vianna, P. T. G., & Massone, F. (2015). Hemodynamic effects of target-controlled infusion of propofol alone or in combination with a constant-rate infusion of remifentanil in dogs. Canadian Journal of Veterinary Research, 79(4), 309–315.

Bernicker, E. T., Spengler, A., Lima, A. A., Romani, C. A., Trentin, L. W., Manozzo, R. L., & Libardoni, R. N. (2021). Hérnia perineal associada a divertículo retal em um cão: Relato de caso. PUBVET, 15(10), 1–6. https://doi.org/10.31533/pubvet.v15n10a942.1-6.

Blancquaert, J.-P., Lefebvre, R. A., & Willems, J. L. (1986). Emetic and antiemetic effects of opioids in the dog. European Journal of Pharmacology, 128(3), 143–150. https://doi.org/10.1016/0014-2999(86)90760-0.

Bressan, T. F. (2017). Localização dos receptores opioides no sistema nervoso central e avaliação dos efeitos analgésico e sedativo da morfina e butorfanol em iguanas verdes (Iguana iguana). Universidade de São Paulo.

Chanavaz, C., Tirel, O., Wodey, E., Bansard, J.-Y., Senhadji, L., Robert, J.-C., & Ecoffey, C. (2005). Haemodynamic effects of remifentanil in children with and without intravenous atropine. An echocardiographic study. British Journal of Anaesthesia, 94(1), 74–79. https://doi.org/10.1093/bja/aeh293.

Doyle, D. J., Hendrix, J. M., & Garmon, E. H. (2017). American society of anesthesiologists classification.

Ferraz, R. E. O., Rodrigues, I. R., Macedo, H. J. R., Albuquerque, Á. H., Feitosa, A. S., Freitas, V. M. L., & Oliveira, A. L. A. (2017). Hérnia perineal complicada com envolvimento de intestino e bexiga em cão: Relato de caso. PUBVET, 11(9), 882–888. https://doi.org/10.22256/pubvet.v11n9.882-888.

Fossum, T. W. (2021). Cirurgia de pequenos animais (3ed.). Elsevier Editora.

Gill, S. S., & Barstad, R. D. (2018). A review of the surgical management of perineal hernias in dogs. Journal of the American Animal Hospital Association, 54(4), 179–187. https://doi.org/10.5326/JAAHA-MS-6490.

Gimenes, A. M., Aguiar, A. J. A., Perri, S. H. V., & Nogueira, G. P. (2011). Effect of intravenous propofol and remifentanil on heart rate, blood pressure and nociceptive response in acepromazine premedicated dogs. Veterinary Anaesthesia and Analgesia, 38(1), 54–62. https://doi.org/10.1111/j.1467-2995.2010.00579.x.

Grond, S., Radbruch, L., & Lehmann, K. A. (2000). Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl. Clinical Pharmacokinetics, 38, 59–89.

Keene, B. W., Atkins, C. E., Bonagura, J. D., Fox, P. R., Häggström, J., Fuentes, V. L., Oyama, M. A., Rush, J. E., Stepien, R., & Uechi, M. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of Veterinary Internal Medicine, 33(3), 1127–1140. https://doi.org/10.1111/jvim.15488.

Marques, M. G., Cancelli, C. H. B., Fernandes, C. M. S., Games, B. M. M., Floriano, B. P., Perri, S. H. V, Sousa, M. G., Ferreira, W. L., & Santos, P. S. P. (2018). Effect of a constant rate infusion of remifentanil hydrochloride on left ventricular systolic and diastolic function in propofol-anesthetized dogs. American Journal of Veterinary Research, 79(12), 1261–1267. https://doi.org/10.2460/ajvr.79.12.1261.

Penaforte Júnior, M. A., Aleixo, G. A. S., Maranhão, F. E. C. B., & Andrade, L. S. S. (2015). Hérnia perineal em cães: revisão de literatura. Medicina Veterinária, 9(1–4), 26–35.

Rego, R. O., Henrique, F. V., Felipe, G. C., Medeiro, L. K. G., Araújo, S. B., Oliveira Júnior, A. G., Alves, A. P., Costa Neto, J. M., & Nóbrega Neto, P. I. (2016). Tratamento cirúrgico da hérnia perineal em cães pela técnica de elevação do músculo obturador interno e reforço com cartilagem auricular suína ou tela de polipropileno. Brazilian Journal of Veterinary Medicine, 38(Supl. 1), 99–107.

Scarparo, V. A., Gorczak, R., & Valandro, M. A. (2020). Anestesia em pacientes de risco: uma abordagem anestésica aos pacientes cardiopatas, nefropatas, hepatopatas, pediátricos e senis. Revista Veterinária Em Foco, 17(2).

Souza, D. B., & Abílio, E. J. (2007). Hérnia perineal em cães: revisão de literatura. Clínica Veterinária, 68, 78–86.

Videira, R. L. R., & Cruz, J. R. S. (2004). Remifentanil na prática clínica. Revista Brasileira de Anestesiologia, 54, 114–128. https://doi.org/10.1590/S0034-70942004000100016.

Published

2023-12-13

Issue

Section

Medicina veterinária

How to Cite

1.
Monteiro AE de S, Silva MB do V. Constant rate infusion of remifentanil in a cardiac patient for Perineal Hernia repair. Pubvet [Internet]. 2023 Dec. 13 [cited 2024 Dec. 22];17(13):e1514. Available from: https://ojs.pubvet.com.br/index.php/revista/article/view/3408