| Abstract | Ovarijektomija kuje jedan je od najčešće izvođenih zahvata u veterinarskoj medicini. Uz
laparotomsku metodu sve je veći trend izvođenja minimalno invazivne tehnike odnosno
laparoskopske ovarijektomije. Osim specijalne kirurške opreme za izvođenje laparoskopske
ovarijektomije potrebna je i odgovarajuća anestezija. U današnje vrijeme sve se više koristi
princip multimodalne analgezije uz uporabu neopioida. Maropitant pripada skupini
antiemetičkih lijekova namijenjen za liječenje i sprječavanje povraćanja. Antagonist je
receptora NK-1 koji posjeduje jedinstvena anksiolitička, antidepresivna i antiemetička svojstva.
Svojim antagonizmom prema NK-1 receptorima, maropitant osigurava i analgeziju blokiranjem
farmakološkog učinka tvari P na mozak i leđnu moždinu. Ovim istraživanjem analizirani su
podaci praćeni na 30 kuja tijekom izvođenja laparoskopske ovarijektomije na Klinici za
porodništvo i reprodukciju Veterinarskog fakulteta u Zagrebu. U istraživanju su bila uključena
dva anesteziološka protokola, oba su u premedikaciji uključivala opioid (metadon) te agonist
adrenergičnih receptora (medetomidin) dok se za indukciju koristio brzo djelujući hipnotik
(propofol). U jednom protokolu se prije indukcije anestezije primijenio NK-1 antagonist
(maropitant) 1mg/kg i.v., a u drugom prije početka zahvata bolus opioida (fentanil). Obrađeno
je ukupno 30 anestezioloških protokola, odnosno 15 protokola koji uključuju opioid (fentanil)
te 15 protokola koji uključuju NK1- antagoniste (maropitant). Podaci o kujama uključivali su
preoperativne vrijednosti trijasa, a tijekom anestezije prikupljeni su podatci o vrijednostima
bila, disanja, srednjeg tlaka i etCO2. Dobivenim rezultatima uočeno je da se primjenom
maropitanta u premedikaciji, smanjuje potreba za upotrebom opioida tijekom zahvata
laparoskopske ovarijektomije te da nema značajne razlike u vrijednostima disanja, etCO2,
sistoličkog, dijastoličkog i srednjeg tlaka između kuja koje su primile maropitant prije indukcije
i onih kuja kojima je apliciran bolus fentanila. |
| Abstract (english) | Ovariectomy in bitches is one of the most commonly performed procedures in veterinary
medicine. In addition to the laparotomy method, a minimally invasive technique, laparoscopic
ovariectomy, is increasingly being used. Laparoscopic ovariectomy requires not only special
surgical equipment but also appropriate anesthesia. Nowadays, the principle of multimodal
analgesia with the use of non-opioids is increasingly applied. Maropitant belongs to the group
of antiemetics used to treat and prevent vomiting. It is an antagonist of the NK-1 receptor, which
has unique anxiolytic, antidepressant, and antiemetic properties. Through its antagonism to NK-
1 receptors, maropitant also has analgesic effects by blocking the pharmacological effects of
substance P on the brain and spinal cord. In this study, data were analyzed from 30 bitches
observed during laparoscopic ovariectomy at the Department of Obstetrics and Reproduction,
Faculty of Veterinary Medicine, Zagreb. The study included two anesthetic protocols, both
containing an opioid (methadone), and an adrenergic receptor agonist (medetomidine) as
premedication, while a rapid-acting hypnotic (propofol) was used for induction. In one protocol,
an NK-1 antagonist (Maropitant) 1mg/kg i.v was administered before induction of anesthesia,
while in the other protocol, an opioid bolus (Fentanyl) was administered before the start of the
procedure. A total of 30 anesthetic protocols were processed, i.e., 15 protocols with an opioid
(fentanyl) and 15 protocols with an NK1 antagonist (maropitant). Data included preoperative
and intraoperative temperature, respiration, and heart rate values. In addition, systolic, diastolic,
mean pressure, and etCO2 were measured during surgical procedures. The results show that the
use of maropitant as a premedication reduces the need for opioids during laparoscopic
ovariectomy and that there is no significant difference in respiratory, etCO2, systolic, diastolic,
and mean pressure values between females that received maropitant before induction and
females that were administered fentanyl bolus. |
