Anestesia geral multimodal para celiotomia exploratória em equino (Equus ferus caballus) acometido por síndrome do abdomen agudo – Relato de caso

Abstract

The Mandatory Supervised Internship (referred as ESO in portuguese) in Veterinary Medicine was conducted in the fields of Veterinary Anesthesiology and Equine Clinic and Surgery from April 1 to 30, 2024, at the FZEA/USP-Pirassununga Veterinary Hospital, under the supervision of Prof. Dr. Adriano Bonfim Carregaro; from May 1 to 31, 2024, at the Clínica Veterinária Guadalupe, under the supervision of M.V. Guilherme Alberto Machado; and from June 1 to 30, 2024, at the FMVZ/UNESP-Botucatu Veterinary Hospital, under the supervision of Prof. Dr. Antônio José de Araújo Aguiar. The activities were coordinated by Prof. Dr. André Mariano Batista and totaled 424 hours. This internship provided exposure to the anesthetic routines at USP and UNESP hospitals and the general routine at Clínica Guadalupe. The work aimed to report a case of multimodal general anesthesia for exploratory celiotomy in an equine patient with acute abdomen syndrome. The procedure was performed on a 6-year-old female horse with a history of severe abdominal pain unresponsive to clinical treatment. The acute abdomen syndrome was caused by a fecalith in the descending colon, which was removed during the emergency surgery. Anesthesia was induced with ketamine (2.2 mg/kg) and midazolam (0.1 mg/kg), maintained with isoflurane (2% vol.) in 100% oxygen with mechanical ventilation, and a continuous infusion of lidocaine at 3 mg/kg/h. Due to severe hypotension recorded by the multiparameter monitor, dobutamine, norepinephrine, and hypertonic solution were used to correct this alteration, and fluid therapy with Ringer Lactate and NaCl 0.9% was combined to maintain blood volume. Blood gas analisys monitoring was crucial for assessing the patient's ventilatory function and the need for calcium, potassium, and sodium bicarbonate replacement. With the stabilization maneuvers performed, the patient remained stable throughout the procedure. Post-surgery, the animal experienced a prolonged and poor-quality anesthetic recovery, likely due to systemic changes related to the clinical condition. Thus, equine anesthesia in cases of colic is challenging and requires the anesthetist to have extensive knowledge and practice in physiology, pathophysiology, and pharmacology to achieve satisfactory results.