Aspectos trans e pós cirúrgicos da técnica de tumescência nas mastectomias em felinos

Abstract

The aim of the present study was to establish the trans and post-surgical influence of the use of tumescence on cat mastectomies regarding the time of surgery, bleeding, feasibility, wound healing and possible complications. Fifteen cats, ovariohysterectomized and with mammary neoplasia between 4 and 19 years of age, without predilection of race, weighing between 2 and 5 kg were used. The cats were divided into: GF (Fentanyl Group) with 7 cats and GT (Tumescence Group) with 8 cats. All animals received Meperidine at the dose of 4mg / kg (IM) previously. In both groups, the Blue Patent V 2.5% dye (2mg / kg) was applied in the peritumoral subcutaneous region to observe the sentinel lymph node. In this period, a 0.5 ml blood sample was collected for the evaluation of the preoperative hematocrit (Ht 1), the induction performed with Propofol (5mg / kg) and then intubation. The anesthetic maintenance was with Isofluorane following the plans of Guedel (Plan II / Stage III). In the GT group Klein's cannula was used to infuse the tumescent solution. The mastectomy was performed in total unilateral chain at times: TCr (cranial thoracic) TCa (caudal thoracic) Ab (abdominal) I (inguinal). For statistical purposes the time of each procedure was timed. The compresses were weighed at the beginning and at the end of each procedure. The surgeon was asked about transoperative bleeding. In the immediate postoperative period the animals had their pain scores assessed. In the GF group, 2.5 mcg of slow intravenous Fentanyl Citrate was given followed by continuous infusion at the rate of 10 mcg / kg / hour in the first hour to 5 mcg / kg / hour in the following hour. On days 2, 7 and 14 of the postoperative period the animals underwent a visual cicatricial evaluation, performing the collection of blood to the hematocrit (Ht 2) on the first postoperative day, and calculating the estimate of blood loss. All mammary chains were histologically evaluated in order to allow prognosis evaluation and oncological follow-up. The time of removal of the mammary chain was better in the GT group, the technique did not interfere in the time of removal of the points and was not able to bring about loss in relation to the blood loss, facilitated the decidual divulsion and only two animals presented bluish coloration in the mucosa due To the use of patent blue contrast V with improved coloration in 24 hours. The technique was effective in maintaining analgesia 60 minutes after procedure and greater patient comfort was observed 24 hours later. Wound appearance and tissue resistance were not impaired by the tumescence technique, with the advantage of maintaining hyperemia, pain and temperature at the site of the surgery, hematomas were smaller and less frequent in the GT group, during the period of six Months of post-surgical follow-up, only three animals died, of which two relapsed, the same animals where the contrast was unable to stain the lymph node, and concluded that the sentinel lymph node technique can also be used as a prognostic factor