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2010 | 66 | 09 |

Tytuł artykułu

Przydatność tumescencyjnego znieczulenia nasiękowego w wybranych zabiegach operacyjnych u psów

Warianty tytułu

EN
Usefulness of tumescent local anesthesia in selected surgical procedures in dogs

Języki publikacji

PL

Abstrakty

EN
Tumescent local anesthesia (TLA) is a kind of local anesthesia that consists in the application of large amounts of highly diluted buffered solution of local anesthetic with addition of a vasoconstrictor. Advantages of this type of anesthesia are a significant reduction in bleeding from the operated tissues and a long-lasting analgesia during the postoperative period. The aim of this study was to assess the usefulness of TLA in dogs (15 animals: 7 males and 8 females, 6-13 years old; 11-60 kg b.w.) which were subjected to surgical procedures characterized by significant intraoperative bleeding and severe painfulness in the postoperative period (hemimastectomy, vertical ear canal ablation, shoulder disarticulation amputation). TLA was performed on animals that had been subjected to general anesthesia preceded by sterile skin preparation. The injection of the tumescent fluid (containing 50 mg of lidocaine, 0,1 mg of adrenaline, 84 mg of sodium bicarbonate and isotonic saline ad 100 ml) was started immediately after the needle insertion and continued while penetrating deeper tissues. The fluid was injected until a distinct deformation of the injected area appeared. A characteristic aspect of tissues subjected to TLA (gelatinous swelling and local ischemia) was observed while performing the operation. During the postoperative period all the animals were observed for 12 hours in order to assess their pain, using the short form of the Glasgow composite pain scale. In cases of 3 dogs the recommended analgesic intervention level was exceeded during the observation. No symptoms of lidocaine overdose appeared in any of the operated animals. Operative wounds healed by first intention in all the animals. Based on the results achieved, it can be concluded that in the case of dogs tumescent local anesthesia facilitates surgical procedures characterized by abundant intraoperative bleeding and provides long-lasting postoperative analgesia.

Wydawca

-

Rocznik

Tom

66

Numer

09

Opis fizyczny

s.626-629,fot.,tab.,bibliogr.

Twórcy

autor
  • Zakład Chirurgii i Anestezjologii Małych Zwierząt, Wydział Medycyny Weterynaryjnej, Szkoła Główna Gospodarstwa Wiejskiego, ul.Nowoursynowska 159 C, 02-776 Warszawa
autor
autor

Bibliografia

  • 1.Abelson A. L., McCobb E. C., Shaw S., Armitage-Chan E., Wetmore L. A., Karas A. Z., Blaze C.: Use of wound soaker cathethers for the administration of local anesthetic for post-operative analgesia: 56 cases. Vet. Anaest. Analg. 2009, 36, 597-602.
  • 2.Agarwal P.: Safe method for relase of severe post burn neck contracture under tumescent local anesthesia and ketamine. Ind. J. Plast. Surg. 2004, 37, 51-54.
  • 3.Bieniek A., Orzechowska-Juzwenko K., Głowacka K., Hurkacz M., Terpiński J.: Tumescencyjne znieczulenie nasiękowe (TZN) i jego praktyczne znaczenie we współczesnej chirurgii. Medpharm, Wrocław 2007.
  • 4.Breuninger H.: Semi-automated, slow subcutanealis infusion anesthesia (SIA) with diluted mixtures of prilocaine and ropivacaine. Eur. J. Plast. Surg. 2004, 26, 391-396.
  • 5.Bussolin L., Busoni P., Giorgi L., Crescioli M., Messeri A.: Tumescent local anesthesia for the surgical treatment of burns and postburn sequelae in pediatric patients. Anesthesiology 2003, 99, 1371-1375.
  • 6.Dobromylskyj P., Flecknell P. A., Lascelles B. D., Pascoe P. J., Taylor P., Waterman-Pearson A.: Management of postoperative and other acute pain, [w:] Flecknell P., Waterman-Pearson A. (red.): Pain Management in Animals. Saunders W. B., London 2000, 81-145.
  • 7.Egger C., Love L.: Techniki znieczulenia miejscowego i regionalnego. Cz. I. Przegląd pięciu prostych metod. Weterynaria po dyplomie 2009, 10, 6-18.
  • 8.Eichhorn K., Renner R., Haustein U. F.: Sentinel node biopsy in melanoma of the trunk and the extremities in tumescent local anesthesia. Dermatol. Surg. 2004, 30, 253-256.
  • 9.Hellyer P. W., Robertson S. A., Fails A. D.: Pain and its management, [w:] Tranquilli W. J., Thurmon J. C., Grimm K. A. (red.): Lumb&Jones' Veterinary Anesthesia and Analgesia. Blackwell Publishing, Ames, 2007, 42-45.
  • 10.Klein J. A.: The tumescent technique for liposuction surgery. Am. J. Cosmet. Surg. 1987, 4, 263-267.
  • 11.Ko J., Weil A., Maxwell L., Kitao T., Haydon T.: Plasma concentrations of lidocaine in dogs following lidocaine path application. J. Am. Anim. Hosp. Assoc. 2007, 43, 280-283.
  • 12.Kryst L., Mayzner-Zawadzka E.: Znieczulenie w praktyce stomatologicznej. PZWL, Warszawa 2001, s. 20.
  • 13.Mizukami T., Hamamoto M.: Tumescent local anesthesia for a revascularization of a coronary subclavian steal syndrome. Ann. Thorac. Cardiovasc. Surg. 2007, 13, 352-354.
  • 14.Narita M., Sakano S., Okamoto S., Uemoto S., Yamamoto M.: Tumescent local anesthesia in inguinal herniorrhaphy with a prolene hernia system: original technique and results. Am. J. Surg. 2009, 198, 27-31.
  • 15.Papadopoulos O., Konofaos P., Medvedev V., Chrisostomidis C.: Island vertical trapezius myocutaneous flap procedure under the tumescent technique. Europ. Surg. Res. 2007, 39, 118-121.
  • 16.Savvas I., Papazoglou L. G., Kazakos G., Anagnostou T., Tsioli V., Raptopoulos D.: Incisional block with bupivacaine for analgesia after celiotomy in dog. J. Am. Anim. Hosp. Assoc. 2008, 44, 60-66.
  • 17.Shoher A., Hekier R., Lucci Jr. A.: Mastectomy performed with scissors following tumescent solution injection. J. Surg. Oncol. 2003, 83, 191-193.
  • 18.Skarda R. T., Tranquilli W. J.: Local and regional anesthetic and analgesic techniques: dogs, [w:] Tranquilli W. J., Thurmon J. C., Grimm K. A. (red.): Lumb&Jones' Veterinary Anesthesia and Analgesia. Blackwell Publishing, Ames 2007, 561-594.
  • 19.Wolfe T. M., Bateman S. W., Cole L. K., Smeak D. D.: Evaluation of a local anesthetic delivery system for total ear canal ablation - a randomized, controlled, double-blinded study. Vet. Anaest. Analg. 2006, 33, 328-339.

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Typ dokumentu

Bibliografia

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