engleski

Anaesthesia protocol for laparoscopic ovariectomy in bitch diagnosed with immune- mediated meningoencephalitis

A Parson Jack Russell Terrier (Fila), a 4-year- old intact female, was referred to the Clinic for a clinical examination prior to laparoscopic ovariectomy. The patient had a history of suspected hormone-induced atopic dermatitis and immune-mediated meningoencephalitis. The bitch underwent the physical examination, which was unremarkable. Haematology and serum biochemistry profile showed no significant abnormalities. Other diagnostic procedures, X-ray and electrocardiography (ECG) were all normal as well. Total intravenous anaesthesia (TIVA) has been suggested as the preferred anaesthetic technique in patients with a risk of increased intracranial pressure. Inhalation anaesthetics affect intracranial pressure, which can be increased through a direct vasodilation of cerebral vasculature. Considering the mentioned, a laparoscopic ovariectomy and punch skin biopsy were performed following the propofol-based TIVA protocol. The bitch was premedicated with midazolam (0.3 mg/kg IM) and methadone (0.5 mg/ kg IM). General anaesthesia was induced with propofol (3 mg/kg IV), followed by endotracheal intubation. The patient was connected to the anaesthetic machine with a rebreathing circuit, with the oxygen flow of 2.0 L/min. General anaesthesia was maintained with propofol (0.2 mg /kg/min IV). During the procedure, analgesia was provided by using boluses of fentanyl (5 μg/kg IV) Possible complications during the surgery were hypoventilation, hypoxaemia, respiratory depression, bradycardia and hypotension. Patient monitoring included capnometry, pulse oximetry, oscillometric non-invasive arterial blood pressure measurement and ECG. The histopathology findings showed epidermal and follicular atrophy and orthokeratotic hyperkeratosis, which is indicative for endocrine- induced dermopathy. In conclusion, the propofol-based TIVA protocol for the presented case was shown to be a great choice due to advantages such as maintenance of oxygen delivery to the brain, and to avoid potential increases in intracranial pressure from inhalation agents.

bitch ; TIVA protocol ; intracranial pressure

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