Anestesia multimodal em potro: relato de caso

Abstract

This study aims to report the multimodal anesthetic protocol employed in a foal undergoing tibial osteosynthesis, with emphasis on the use of total intravenous anesthesia (TIVA), perineural blocks of the saphenous and sciatic nerves guided by ultrasound and peripheral nerve stimulator with ropivacaine, caudal epidural analgesia with morphine and ketamine, in addition to mechanical ventilation, and serial blood gas monitoring. The surgical procedure was performed under TIVA with continuous infusion of propofol, dexmedetomidine, and ketamine. Although still scarcely described in this species, the saphenous and sciatic nerve blocks proved effective in pain control, allowing for reduced doses of anesthetic drugs and contributing to the stability of physiological parameters throughout anesthesia. Controlled mechanical ventilation ensured adequate gas exchange, preventing respiratory disorders such as hypercapnia and acidosis, which are commonly associated with prolonged anesthesia in dorsal recumbency. Acid-base balance was maintained throughout the procedure, as evidenced by the results of blood gas analysis. Despite the negative outcome, with the patient being euthanized postoperatively due to systemic complications, the anesthetic protocol demonstrated satisfactory results in pain management, maintenance of tissue perfusion, and cardiovascular stability. The combination of TIVA and locoregional blocks emerged as a safe and effective strategy for equine surgeries, especially when associated with mechanical ventilation and intensive monitoring. Based on these findings, the need for further studies on the applicability and effects of perineural blocks of the saphenous and sciatic nerves in horses is evident, in order to expand the anesthetic repertoire in this species and establish multimodal anesthesia as the standard approach for complex procedures.