DENISE AYA OTSUKI
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- Comparison of Epidural and Systemic Tramadol for Analgesia Following Ovariohysterectomy(2012) MASTROCINQUE, Sandra; ALMEIDA, Tatiana F.; TATARUNAS, Angelica C.; IMAGAWA, Viviani H.; OTSUKI, Denise A.; MATERA, Julia M.; FANTONI, Denise T.The objective of the study was to compare epidural and systemic tramadol for postoperative analgesia in bitches undergoing ovariohysterectomy. Twenty animals, randomly divided into two groups, received either epidural (EPI) or intramuscular (IM) tramadol (2 mg/kg) 30 min before anesthetic induction. Analgesia, sedation, cardiorespiratory parameters, end-tidal isoflurane, blood catecholamines and cortisol, and arterial blood gases were measured at different time points up to 24 hr after agent administration. There were no differences between the two groups regarding cardiorespiratory parameters, end-tidal isoflurane, and pain scores. Two dogs in the IM and one in the EPI group required supplemental analgesia. Cortisol was increased (P<0.05) at 120 min (3.59 mu g/dL and 3.27 mu g/dL in the IM and EPI groups, respectively) and 240 min (2.45 mu g/dL and 2.54 mu g/dL in the IM and EPI groups, respectively) compared to baseline. Norepinephrine was also increased (P<0.05) at 120 min in both groups compared to baseline values. Epinephrine values were higher (P<0.05) in the IM group compared with the EPI group at 50 min, 120 min, and 1,440 min after tramadol administration. Epidural tramadol is a safe analgesic, but does not appear to have improved analgesic effects compared with IM administration. (J Am Anim Hosp Assoc 2012; 48:310-319. DOI 10.5326/JAAHA-MS-5795)
- The effect of premedication with ketamine, alone or with diazepam, on anaesthesia with sevoflurane in parrots (Amazona aestiva)(2013) PAULA, Valeria Veras; OTSUKI, Denise Aya; AULER JUNIOR, Jose Otavio Costa; NUNES, Talyta Lins; AMBROSIO, Aline Magalhaes; FANTONI, Denise TabacchiBackground: Premedication is rarely used in avian species. The aim of this study was to evaluate the effect of premedication on the quality of sevoflurane induction and anaesthesia in parrots. We hypothesised that premedication would facilitate handling and decrease the minimum anaesthetic dose (MAD). Thirty-six adult parrots were randomly distributed in three groups: group S (n = 12) was premedicated with NaCl 0.9%; group KS (n = 12) was premedicated with 10 mg.kg(-1) ketamine; and group KDS (n = 12) was premedicated with 10 mg.kg(-1) ketamine and 0.5 mg.kg(-1) diazepam, delivered intramuscularly. After induction using 4.5% sevoflurane introduced through a facemask, the MAD was determined for each animal. The heart rate (HR), respiratory rate (RR), systolic arterial blood pressure (SAP), and cloacal temperature (CT) were recorded before premedication (T0), 15 minutes after premedication (T1), and after MAD determination (T2). Arterial blood gas analyses were performed at T0 and T2. The quality of anaesthesia was evaluated using subjective scales based on animal behaviour and handling during induction, maintenance, and recovery. Statistical analyses were performed using analysis of variance or Kruskal-Wallis tests followed by Tukey's or Dunn's tests. Results: The minimal anaesthetic doses obtained were 2.4 +/- 0.37%, 1.7 +/- 0.39%, and 1.3 +/- 0.32% for groups S, KS, and KDS, respectively. There were no differences in HR, RR, or CT among groups, but SAP was significantly lower in group S. Sedation was observed in both the premedicated S-KS and S-KDS groups. There were no differences in the quality of intubation and recovery from anaesthesia among the three groups, although the induction time was significantly shorter in the pre-medicated groups, and the KS group showed less muscle relaxation. Conclusions: Ketamine alone or the ketamine/diazepam combination decreased the MAD of sevoflurane in parrots (Amazona aestiva). Ketamine alone or in combination with diazepam promoted a good quality of sedation, which improved handling and reduced the stress of the birds. All protocols provided safe anaesthesia in this avian species.
- A comparison of the cardiopulmonary effects of pressure controlled ventilation and volume controlled ventilation in healthy anesthetized dogs(2016) FANTONI, Denise T.; IDA, Keila K.; LOPES, Thomas F. T.; OTSUKI, Denise A.; AULER JR., Jose Otavio C.; AMBROSIO, Aline M.Objective - To compare the effects of pressure controlled ventilation (PCV) with volume-controlled ventilation (VCV) on lung compliance, gas exchange, and hemodynamics in isoflurane-anesthetized dogs. Design - Prospective randomized study. Setting - Veterinary teaching hospital. Animals - Forty client-owned bitches undergoing elective ovariohysterectomy. Interventions - Dogs were randomly assigned to be ventilated with 100% oxygen using PCV (n = 20) or VCV (n = 20). The respiratory rate was 20/min and positive end-expiratory pressure (PEEP) was 5 cm H2O, with a tidal volume of 10 mL/kg. Cardiac output (CO) was measured using thermodilution. Cardiopulmonary and blood gas data were obtained during spontaneous ventilation and after 30 (T30) and 60 minutes (T60) of controlled ventilation. Measurements and Main Results - In dogs ventilated with PCV, at T30 and T60, PIP was lower (11.4 +/- 1.9 and 11.1 +/- 1.5 cm H2O, respectively) and static compliance (C-ST) was higher (51 +/- 7 and 56 +/- 6 mL/cm H2O, respectively) than in VCV group (PIP of 14.3 +/- 1.3 and 15.5 +/- 1.4 cm H2O; C-ST of 34 +/- 8 and 33 +/- 9 mL/cm H2O, P < 0.0001). Compared with spontaneous ventilation, both groups had decreased alveolar-arterial oxygen difference at T30 and T60 (PCV: 128 +/- 32 mm Hg vs 108 +/- 20 and 104 +/- 16 mm Hg, respectively; VCV: 131 +/- 38 mm Hg vs 109 +/- 19 and 107 +/- 14 mm Hg, respectively; P < 0.01), while CO was maintained at all time points. Conclusions - Compared to spontaneous ventilation, both ventilatory modes effectively improved gas exchange without hemodynamic impairment. PCV resulted in higher lung C-ST and lower PIP compared to VCV.
- Computed Tomography Assessment of Tidal Lung Overinflation in Domestic Cats Undergoing Pressure-Controlled Mechanical Ventilation During General Anesthesia(2022) MARTINS, Alessandro R. C.; AMBROSIO, Aline M.; FANTONI, Denise T.; PINTO, Ana Carolina B. C. F.; VILLAMIZAR-MARTINEZ, Lenin Arturo; SOARES, Joao H. N.; OTSUKI, Denise A.; MALBOUISSON, Luiz Marcelo S.ObjectiveThis study aimed to evaluate lung overinflation at different airway inspiratory pressure levels using computed tomography in cats undergoing general anesthesia. Study DesignProspective laboratory study. AnimalsA group of 17 healthy male cats, aged 1.9-4.5 years and weighing 3.5 +/- 0.5 kg. MethodsSeventeen adult male cats were ventilated in pressure-controlled mode with airway pressure stepwise increased from 5 to 15 cmH(2)O in 2 cmH(2)O steps every 5 min and then stepwise decreased. The respiratory rate was set at 15 movements per min and end-expiratory pressure at zero (ZEEP). After 5 min in each inspiratory pressure step, a 4 s inspiratory pause was performed to obtain a thoracic juxta-diaphragmatic single slice helical CT image and to collect respiratory mechanics data and an arterial blood sample. Lung parenchyma aeration was defined as overinflated, normally-aerated, poorly-aerated, and non-aerated according to the CT attenuation number (-1,000 to -900 HU, -900 to -500 HU, -500 to -100 HU, and -100 to +100 HU, respectively). ResultAt 5 cmH(2)O airway pressure, tidal volume was 6.7 +/- 2.2 ml kg(-1), 2.1% (0.3-6.3%) of the pulmonary parenchyma was overinflated and 84.9% (77.6%-87.6%) was normally inflated. Increases in airway pressure were associated with progressive distention of the lung parenchyma. At 15 cmH(2)O airway pressure, tidal volume increased to 31.5 +/- 9.9 ml kg(-1) (p < 0.001), overinflated pulmonary parenchyma increased to 28.4% (21.2-30.6%) (p < 0.001), while normally inflated parenchyma decreased 57.9% (53.4-62.8%) (p < 0.001). Tidal volume and overinflated lung fraction returned to baseline when airway pressure was decreased. A progressive decrease was observed in arterial carbon dioxide partial pressure (PaCO2) and end-tidal carbon dioxide (ETCO2) when the airway pressures were increased above 9 cmH(2)O (p < 0.001). The increase in airway pressure promoted an elevation in pH (p < 0.001).
- Cyclooxygenases 1 and 2 inhibition and analgesic efficacy of dipyrone at different doses or meloxicam in cats after ovariohysterectomy(2021) PEREIRA, Marco A. A.; CAMPOS, Karina D.; GONCALVES, Lucas A.; SANTOS, Rosana S. T. dos; FLOR, Patricia B.; AMBROSIO, Aline M.; OTSUKI, Denise A.; MATERA, Julia M.; GOMES, Cristina O. M. S.; FANTONI, Denise T.Objective To evaluate the cyclooxygenases (COX) inhibition, adverse effects and analgesic efficacy of dipyrone or meloxicam in cats undergoing elective ovariohysterectomy. Study design Prospective, blinded, randomized, clinical study. Animals A total of 30 healthy young cats. Methods The cats were randomly assigned to three postoperative groups: D25 (dipyrone 25 mg kg(-1) every 24 hours), D12.5 (dipyrone 12.5 mg kg(-1) every 12 hours) and M (meloxicam 0.1 mg kg(-1) every 24 hours). In the first 24 hours, the drugs were administered intravenously (IV), and then orally for 6 (dipyrone) or 3 days (meloxicam). Prostanoids thromboxane B-2 and prostaglandin E-2 concentrations served as indicators of COX activity and, with physiological variables and pain and sedation scores, were measured for 24 hours after first analgesic administration. Rescue analgesia (tramadol, 2 mg kg(-1) IV) was provided if Glasgow feline composite measure pain scale (CMPS-Feline) >= 5. Laboratory tests included symmetric dimethylarginine and adverse effects were evaluated regularly up to 7 and 10 days after surgery, respectively. Parametric and nonparametric data were analyzed with two-way ANOVA and Kruskal-Wallis tests, respectively (p < 0.05). Results In the first half hour after analgesic administration, COX-1 activity was close to zero and remained significantly lower than before drug administration for 24 hours in all groups. The inhibition of COX-2 activity was significant for 30 minutes in all groups and up to 4 hours in group M. No alterations in laboratory tests or significant adverse effects were observed. Pain scores and need for rescue analgesia did not differ statistically among groups. Conclusions Dipyrone at both doses and meloxicam provided a nonselective inhibition of COX-1 and -2 activities and effective analgesia without causing significant adverse effects or laboratory tests alterations.
- Effects of bilateral topical administration of repeated doses of rocuronium bromide as a mydriatic agent in Amazon parrots (Amazona aestiva and Amazona amazonica)(2021) DONGO, Pamela S. J.; PINTO, Debora G.; GUIMARAES, Marta B.; OTSUKI, Denise A.; SAFATLE, Angelica M. V.; BOLZAN, Aline A.The effects of bilateral topical application of repeated doses of rocuronium in parrots are unknown, motivating this research. These effects were evaluated in 24 healthy adult Amazon parrots (12 Amazona aestiva and 12 Amazona amazonica). Three different doses of rocuronium bromide (10 mg/mL) were applied with a micropipette onto the cornea: a single instillation of 20 mu L/eye; two instillations of 20 mu L/eye, spaced 15 minutes apart; and three instillations of 20 mu L/eye, spaced 15 minutes apart. Pupillary diameter (PD) was measured with a digital caliper before treatments (TO), every 15 minutes during the first hour postadministration (T15, T30, T45, T60), hourly for 6 hours (T120, T180, T240, T300, T360), and after 24 hours (T24h). Significant differences were observed between TO and T15 -T120 with a single instillation and between TO and T15-T360 with double and triple instillations. The maximum median PDs were 3.47 mm (T45 one instillation), 3.88 mm (T45 two instillations), and 4.09 mm (T30 three instillations). PD returned to baseline at T180 with one instillation and at T24h with double and triple instillations. All protocols showed similar PD values at TO and T24h. Transient lower eyelid paresis was the only adverse effect observed. Bilateral topical administrations of two and three repeated rocuronium bromide doses produced adequate mydriasis in Amazon parrots and may be indicated for longer ophthalmic procedures.
- Evaluation of the effects of methadone and tramadol on postoperative analgesia and serum interleukin-6 in dogs undergoing orthopaedic surgery(2014) CARDOZO, Larissa B.; COTES, Lourenco C.; KAHVEGIAN, Marcia A. P.; RIZZO, Maria Fernanda C. I.; OTSUKI, Denise A.; FERRIGNO, Cassio R. A.; FANTONI, Denise T.Background: Acute postsurgical pain is of great interest due to potential risk of becoming chronic if not treated properly, worsening patient's recovery and quality of life. Twenty-eight dogs with ruptured cruciate ligaments were divided into three groups that received intramuscular injections of 4 mg/kg of tramadol (TRA), 0.5 mg/kg of methadone (MET0.5), or 0.7 mg/kg of methadone (MET0.7). Physiological parameters (heart and respiratory rates and blood pressure) were evaluated at specified times: baseline (TBL), 1 (T1), 2 (T2), 4 (T4), 6 (T6), and 24 (T24) hours after premedication. Pain scores were described by visual analogue scale (VAS), modified Glasgow Composite, and Colorado University Acute Pain scales. Blood samples for measurement of interleukin (IL)-6 were collected at TBL, T1, T6, and T24. This was a prospective, randomised investigation to evaluate the efficacy of tramadol and methadone as premedications in dogs undergoing osteotomies. Results: There were no statistically significant differences between groups with respect to age, weight, gender, surgery time, and time to extubation. Heart rate, respiratory rate, and blood pressure values were maintained within acceptable ranges, and a reduction was observed at T2 in MET0.5 and MET0.7 compared with TBL. Increases in VAS scores were observed in TRA at T4 compared with TBL, T1, and T24 and between T1 and T6 (p < 0.001). In MET0.5, there was significant increase in VAS score at T4 compared with T1 (p < 0.001). TRA and MET0.5 showed significantly higher mean +/- SD VAS scores (3.4 +/- 2.5 and 2.5 +/- 2.6, respectively) than MET0.7 (1.1 +/- 1.5) at T4 (p < 0.001). TRA showed greater demand of rescue analgesia (four animals in T4 and two in T6) (p < 0.037). There were no statistically significant differences in sedation scores, Colorado Scale scores, or interleukin levels between groups and time points. Conclusions: Methadone given as premedication in doses of 0.7 mg/kg was better at controlling pain compared with lower doses and tramadol. However, dosage increases, administered as rescue analgesia, promoted adequate pain control even in tramadol group. Influence of these analgesics on IL-6 release could not be demonstrated, but significant levels were not found.
- Applicability of optical coherence tomography in blue-fronted parrots (Amazona aestiva)(2020) PECORA, Ricardo Augusto; WATANABE, Sung Song; GUIMARAES, Marta Brito; OTSUKI, Denise Aya; BARROS, Paulo Sergio de Moraes; SAFATLE, Angelica de Mendonca VazObjective Optical coherence tomography (OCT) measurement of adult blue-fronted parrots (Amazona aestiva), free from infectious, inflammatory or neoplastic systemic diseases and from any ophthalmological illness, aim at its characterization, as well as to standardize the examination technique for the species. Procedure Pupillary dilation was achieved with rocuronium bromide (5 mg/mL) at 0, 2, 15, 17, 30, and 32 minutes. The animals were sedated with midazolam maleate (0.5 mg/kg/IM) and anesthetized with propofol (5.0 mg/kg/IV). Measurements were made to evaluate the thickness of the total retina (TR), sensorineural retinal (SR), and ganglion cell complex (GCC), 2 millimeters (mm) from the pecten toward the fovea. OCT data were compared to measurements of retinal histological slides from enucleated eyes of blue-fronted parrots, scanned in automatic fluorescence microscope and measured with by the VS-ASW (R) software. Results Averages of measurements from the 43 retinas evaluated by OCT were TR: 279.40 micrometers (mu m), SR: 255.90 mu m, and GCC: 138.60 mu m, respectively, and the measurements of six retinas using fluorescence microscopy were 260.30 mu m for TR, 238.20 mu m for SR, and 129.30 mu m for GCC, demonstrating a high correlation coefficient between all measurements (r = .8698, P < .0001). It is also possible to evaluate the anatomy of the retina and to identify its layers, variations and abnormalities using OCT images. Variations were found between the different areas of the retina, both in the images of the histological slides and in the images of the OCT. Conclusion Optical coherence tomography is a valuable technique for in vivo evaluation of retinal structures in blue-front parrots, providing detailed and accurate images. This method improves the understanding of retinal diseases, monitoring the beginning, progression and therapy of retinal diseases, in the same individuals during longitudinal studies. In comparison to histological investigations, OCT enables imaging in vivo, therefore reducing the number of euthanized animals or enucleated eyes.
- Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia(2013) IDA, Keila K.; FANTONI, Denise T.; SOUTO, Maria T. M. R.; OTSUKI, Denise A.; ZOPPA, Andre L. V.; SILVA, Luis C. L. C.; AMBROSIO, Aline M.Objective To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Study design Prospective randomized clinical study. Animals Twenty client-owned healthy horses aged 5 +/- 2years, weighing 456 +/- 90kg. Methods In the control group (CG; n=10) weaning was performed by a gradual decrease in respiratory rate (fR) and in the PSV group (PSVG; n=10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2>50 mmHg, arterial pH<7.35 plus PaCO2>50mmHg or PaO2<60mmHg were observed at any time after disconnection from the ventilator until 30minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested. Results Pressure support ventilation group (PSVG) had (mean +/- SD) pH 7.36 +/- 0.02 and PaCO2 41 +/- 3mmHg at weaning and the average lowest PaO2 69 +/- 6mmHg was observed 15minutes post weaning. The CG had pH 7.32 +/- 0.02 and PaCO2 57 +/- 6mmHg at weaning and the average lowest PaO2 48 +/- 5mmHg at 15minutes post weaning. No accuracy in predicting weaning effect was observed for fR (p=0.3474), minute volume (p=0.1153), SaO2 (p=0.1737) and PaO2/PAO2 (p=0.1529). A high accuracy in predicting an optimal effect of weaning was observed for VT>10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p=0.0001), VT/bodyweight>18.5mL kg-1 (p=0.0001) and PaO2/FiO2>298 (p=0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT<10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p= 0.0001) and PeCO238mmHg (p=0.0001) at weaning. Conclusions and clinical relevance Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT, VT/body weight, PaO2/FiO2 ratio and a lower fR/VT ratio and PeCO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.
- Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery(2017) FANTONI, Denise T.; IDA, Keila K.; GIMENES, Andre M.; MANTOVANI, Matheus M.; CASTRO, Jacqueline R.; PATRICIO, Geni C. F.; AMBROSIO, Aline M.; OTSUKI, Denise A.Objective To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. Study design Prospective clinical study. Animals Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. Methods Fluid challenge with lactated Ringer's solution (15 mL kg(-1) in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg(-1)) with hypotension [mean arterial pressure (MAP) < 65 mmHg]. The volume expansion was considered effective if cardiac output (CO; transesophageal Doppler) increased by >= 15%. Cardiopulmonary data were analyzed using two-way ANOVA, receiver operating characteristics (ROC) curves and Spearman coefficient; p < 0.05 was considered significant. Results Effective volume expansion, mean +/- standard deviation 42 +/- 4% increase in CO (p < 0.0001) was observed in 76% of the dogs, resulting in a decrease in PPV (p < 0.0001) and increase in MAP (p < 0.0001), central venous pressure (CVP; p = 0.02) and ejection fraction (p < 0.0001) compared with before the fluid challenge. None of these changes occurred when volume expansion resulted in a nonsignificant CO increase of 4 +/- 5%. No significant differences were observed in blood gas analysis between responsive and nonresponsive dogs. The increase in CO was correlated with the decrease in PPV (r = -0.65; p < 0.0001) but absolute values of CO and PPV were not correlated. The PPV performance (ROC curve area: 0.89 +/- 0.06, p = 0.0011) was better than that of CVP (ROC curve area: 0.54 +/- 0.12) and MAP (ROC curve area: 0.59 +/- 0.13) to predict fluid responsiveness. The best cut-off for PPV to distinguish responders and nonresponders was 15% (50% sensitivity and 96% specificity). Conclusions and clinical relevance In mechanically ventilated, healthy, isoflurane-anesthetized dogs, PPV predicted fluid responsiveness to volume expansion, and MAP and CVP did not show such applicability.