{"id":1138,"date":"2020-09-07T19:05:00","date_gmt":"2020-09-07T22:05:00","guid":{"rendered":"http:\/\/nave.vet.br\/?p=1138"},"modified":"2024-03-02T16:35:00","modified_gmt":"2024-03-02T19:35:00","slug":"monitoracao-anestesica-anestesia-e-o-basico-13","status":"publish","type":"post","link":"https:\/\/nave.vet.br\/en\/video-aulas\/monitoracao-anestesica-anestesia-e-o-basico-13\/","title":{"rendered":"Monitora\u00e7\u00e3o Anest\u00e9sica \u2013 Anestesia \u00e9 o B\u00e1sico #13"},"content":{"rendered":"<div id=\"advads-1420854410\" class=\"advads-antes-do-post advads-entity-placement\" style=\"margin-bottom: 30px;margin-left: auto;margin-right: auto;text-align: center;\"><div class=\"advads-antes-do-post advads-entity-placement\" style=\"text-align: center;\" id=\"advads-734080947\"><div id=\"advads-882705524\"><a href=\"https:\/\/shop.drstanley.com.br\/?utm_source=nave&#038;utm_medium=banner&#038;utm_campaign=nave&#038;utm_id=nave\" aria-label=\"Dr Stanley banner\"><img src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/12\/Dr-Stanley-banner.gif?fit=1000%2C137&#038;ssl=1\" alt=\"\"  width=\"1000\" height=\"137\"   \/><\/a><\/div><\/div><\/div>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"1\u20e32\u20e3 MONITORA\u00c7\u00c3O ANEST\u00c9SICA NA VETERIN\u00c1RIA  | Anestesia e\u0301 o Ba\u0301sico #12\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/e7gU-XiSjoI?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>Ol\u00e1 tripulantes do NAVE, tudo bem? Nessa aula da webserie Anestesia \u00e9 o B\u00e1sico vamos conversar sobre a &#8220;Monitora\u00e7\u00e3o Anest\u00e9sica&#8221;. O sucesso da anestesia est\u00e1 intimamente ligado \u00e0 adequada monitora\u00e7\u00e3o. <\/p>\n\n\n\n<p>Essa deve ser baseada na avalia\u00e7\u00e3o do profundidade anest\u00e9sica, dos par\u00e2metros cardiovasculares, pulmonares e de termorregula\u00e7\u00e3o. H\u00e1 muitos par\u00e2metros importantes na monitora\u00e7\u00e3o, mas aqui n\u00f3s vamos abordar os fundamentais, e essenciais, para que possamos realizar uma anestesia segura. <\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"profundidade-anestesica\">Profundidade Anest\u00e9sica <\/h4>\n\n\n\n<p>A avalia\u00e7\u00e3o da profundidade anest\u00e9sica pode ser determinada sempre que o paciente \u00e9 submetido a anestesia geral. Esse padr\u00e3o foi estabelecido por Guedel, no in\u00edcio do s\u00e9culo XX, e \u00e9 dividido em 4 est\u00e1gios. O est\u00e1gio 3 \u00e9 subdividido em 4 planos, sendo os 2 e 3 considerados planos cir\u00fargicos. Atualmente n\u00f3s seguimos uma nomenclatura um pouco mais flex\u00edvel, dividindo o est\u00e1gio 3 em planos superficial, adequado e profundo. Para isso, utilizamos a avalia\u00e7\u00e3o dos reflexos protetores e altera\u00e7\u00f5es cardiovasculares. Neste <a href=\"http:\/\/nave.vet.br\/en\/webseries\/procedimentos\/planos-anestesicos-em-caes\/\" class=\"rank-math-link\">link<\/a> voc\u00ea pode ver com mais detalhes as caracter\u00edsticas de cada plano anest\u00e9sico.<\/p><div id=\"advads-3674539530\" class=\"advads-adsense-in-article advads-entity-placement\"><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-9687921986569993\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block; text-align:center;\" data-ad-client=\"ca-pub-9687921986569993\" \ndata-ad-slot=\"1211285291\" \ndata-ad-layout=\"in-article\"\ndata-ad-format=\"fluid\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"720\" height=\"535\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Planos-Aneste%CC%81sicos-1.png?resize=720%2C535\" alt=\"\" class=\"wp-image-1204\" style=\"width:562px;height:416px\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Planos-Aneste%CC%81sicos-1.png?w=720&amp;ssl=1 720w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Planos-Aneste%CC%81sicos-1.png?resize=300%2C223&amp;ssl=1 300w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><figcaption class=\"wp-element-caption\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-black-color\">Fonte: Massone F. Planos Anest\u00e9sicos. In: ___ Anestesiologia Veterin\u00e1ria, 7\u00aa ed. 2019, p. 23.<\/mark><\/figcaption><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"monitoracao-cardiovascular\">Monitora\u00e7\u00e3o Cardiovascular <\/h4>\n\n\n\n<p>A monitora\u00e7\u00e3o b\u00e1sica contempla a FC, o tra\u00e7ado eletrocardiogr\u00e1fico e a PA. A FC pode ser obtida de diversos m\u00e9todos, mas o melhor \u00e9 pelo ECG, o qual fornecer\u00e1 a FC e o ritmo ao mesmo tempo. Por\u00e9m, \u00e9 fundamental que a PA sempre seja monitorada, pois assim teremos valores da atividade el\u00e9trica e da eje\u00e7\u00e3o de sangue pelo cora\u00e7\u00e3o. <\/p>\n\n\n<div id=\"advads-839683433\"><a href=\"https:\/\/www.sdamed.com\/\" aria-label=\"Banner-SDAMed NAVE\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2021\/04\/Banner-SDAMed-NAVE-1.gif?fit=496%2C68&#038;ssl=1\" alt=\"\"  width=\"1000\" height=\"137\"   \/><\/a><\/div>\n\n\n<p>O padr\u00e3o-ouro de monitora\u00e7\u00e3o da PA \u00e9 o invasivo, em que necessitamos realizar arteriopun\u00e7\u00e3o. Esse m\u00e9todo nos dar\u00e1 valores cont\u00ednuos e precisos de PA. Tamb\u00e9m podemos monitorar a PA de modo n\u00e3o invasivo, via sistema oscilom\u00e9trico ou doppler arterial. Nesse caso, a metodologia \u00e9 mais f\u00e1cil e r\u00e1pida, mas os valores n\u00e3o s\u00e3o cont\u00ednuos e podemos ter erros de leitura. Outros par\u00e2metros avaliados s\u00e3o o DC, PVC e DeltaPP. <\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized is-style-default\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Captura-de-Tela-2020-09-07-a%CC%80s-14.02.20.png?resize=800%2C450\" alt=\"\" class=\"wp-image-1139\" style=\"width:578px;height:325px\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Captura-de-Tela-2020-09-07-a%CC%80s-14.02.20.png?w=844&amp;ssl=1 844w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Captura-de-Tela-2020-09-07-a%CC%80s-14.02.20.png?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/09\/Captura-de-Tela-2020-09-07-a%CC%80s-14.02.20.png?resize=768%2C432&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"monitoracao-pulmonar\">Monitora\u00e7\u00e3o Pulmonar <\/h4>\n\n\n\n<p class=\"translation-block\">A monitora\u00e7\u00e3o b\u00e1sica contempla a FR, a SpO<sub>2<\/sub> e a ETCO<sub>2<\/sub>. A SpO<sub>2<\/sub> \u00e9 um m\u00e9todo f\u00e1cil e pr\u00e1tico de monitora\u00e7\u00e3o, que fornece a % de hem\u00e1cias com O<sub>2<\/sub>. Valores abaixo de 94% j\u00e1 indicam hip\u00f3xia, o que pode estar associado a quadros de hipoxemia. O ETCO<sub>2<\/sub> \u00e9 outro par\u00e2metro muito importante, pois est\u00e1 intimamente relacionado \u00e0 PaCO<sub>2<\/sub> mas, diferente desse \u00faltimo, o ETCO<sub>2<\/sub> \u00e9 obtido de modo f\u00e1cil e cont\u00ednuo. Ainda podemos avaliar a capnografia que, dependendo do formato da curva, pode nos indicar altera\u00e7\u00f5es no padr\u00e3o respirat\u00f3rio. Outros par\u00e2metros avaliados s\u00e3o a ventilometria e hemogasometria.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"temperatura\">Temperatura <\/h4>\n\n\n\n<p class=\"translation-block\">A temperatura por vezes \u00e9 negligenciada mas \u00e9 muito importante tamb\u00e9m. Quadros de hipotermia culminam em depress\u00e3o cardiovascular, diminui\u00e7\u00e3o do metabolismo cerebral e retardo na recupera\u00e7\u00e3o anest\u00e9sica. Por outro lado, hipertermia pode promover aumento do metabolismo e eleva\u00e7\u00e3o no consumo de O<sub>2<\/sub>. O correto, obviamente, \u00e9 mantermos o paciente em normotermia.<\/p>\n\n\n\n<p>H\u00e1 outros tipos de monitora\u00e7\u00e3o, como j\u00e1 citadas aqui, al\u00e9m do d\u00e9bito urin\u00e1rio, lactato, \u00edndice bispectral dentre outros. Entretanto, o mais importante \u00e9 que seja conhecida a fisiopatologia do paciente, o mecanismo de a\u00e7\u00e3o dos medicamentos utilizados no protocolo anest\u00e9sico e os dados fisiol\u00f3gicos obtidos na monitora\u00e7\u00e3o, para que possamos manter o mesmo em anestesia adequada e pouca depress\u00e3o cardiopulmonar.<\/p>\n\n\n\n\n\n<p><a href=\"http:\/\/nave.vet.br\/en\/?p=1138&amp;preview_id=1138&amp;preview_nonce=c890ed4582&amp;preview=true&amp;_thumbnail_id=1140\" class=\"rank-math-link\">Veja o v\u00eddeo para mais detalhes!<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"leia-tambem\">Read also about:<\/h6>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/procedimentos\/planos-anestesicos-em-caes\/\">Planos Anest\u00e9sicos em C\u00e3es<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/procedimentos\/arteriopuncao-em-caes\/\">Arteriopun\u00e7\u00e3o para press\u00e3o arterial invasiva em c\u00e3es<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/video-aulas\/naveondas\/capnografia\/\">Interpretando as ondas de Capnografia \u2013 NAVE Ondas #1<\/a><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p class=\"has-small-font-size\">Find out more:<br>&#8211; <a class=\"rank-math-link\" href=\"https:\/\/bit.ly\/349NF3r\" target=\"_blank\" rel=\"noopener\">Quadro de Est\u00e1gios e Planos Anest\u00e9sicos em Animais Dom\u00e9sticos<\/a><br>&#8211; Carregaro AB, Silva ANE. Monitora\u00e7\u00e3o Anest\u00e9sica. In: Luna SPL, Carregaro, AB. Anestesia e Analgesia de Equideos, Ruminantes e Su\u00ednos. 247-280, 2019.<br>&#8211; Cerejo et al. Effects of cuff size and position on the agreement between arterial blood pressure measured by Doppler ultrasound and through a dorsal pedal artery catheter in anesthetized cats. <em>Vet Anaesth Analg<\/em>, 47:191-199, 2020. <br>&#8211; Flaherty D, Musk G. Anaesthetic monitoring equipment for small animals. <em>In Practice<\/em>, 27:512-521, 2005. <br>&#8211; Garofalo et al. Agreement between direct, oscillometric and Doppler ultrasound blood pressures using three different cuff positions in anesthetized dogs. <em>Vet Anaesth Analg<\/em>, 39:324-334, 2012. <br>&#8211; Heliczer et al. Accuracy and precision of noninvasive blood pressure in normo-, hyper-, and hypotensive standing and anesthetized adult horses. <em>J Vet Intern Med<\/em>, 30:866-872, 2016.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-css-opacity\"\/>\n\n\n\n<p><strong>Suggestions? Thoughts? Comments? Share!<\/strong><\/p>","protected":false},"excerpt":{"rendered":"<p>Ol\u00e1 tripulantes do NAVE, tudo bem? Nessa aula da webserie Anestesia \u00e9 o B\u00e1sico vamos conversar sobre a &#8220;Monitora\u00e7\u00e3o Anest\u00e9sica&#8221;. O sucesso da anestesia est\u00e1 intimamente ligado \u00e0 adequada monitora\u00e7\u00e3o. Essa deve ser baseada na avalia\u00e7\u00e3o do profundidade anest\u00e9sica, dos par\u00e2metros cardiovasculares, pulmonares e de termorregula\u00e7\u00e3o. H\u00e1 muitos par\u00e2metros&#8230;<\/p>","protected":false},"author":2,"featured_media":1345,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"video","meta":{"give_campaign_id":0,"colormag_page_layout":"default_layout","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[2,1],"tags":[21,27,14,30,429,421,425,424,420,428,423,413,426,124,430,278,415,418,427,19,364,234,422,419,417,416,414,251,82],"class_list":["post-1138","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-video-aulas","category-basico","tag-adriano-carregaro","tag-anestesia-e-o-basico","tag-anestesia-veterinaria","tag-anestesiologia-veterinaria","tag-arterial-pressure-monitoring","tag-capnografia","tag-capnography","tag-capnometria","tag-capnometry","tag-depth-of-anesthesia","tag-doppler-arterial","tag-ecg","tag-eletrocardiografia","tag-monitoracao","tag-monitoracao-anestesica-veterinaria","tag-monitorizacao","tag-monitorizacao-cardiaca","tag-monitorizacao-hemodinamica","tag-multiparametro","tag-nave","tag-nave-anestesia","tag-naveanestesia","tag-oximetria","tag-oximetry-test","tag-planos-anestesicos","tag-planos-de-guedel","tag-pressao-arterial","tag-pressao-arterial-invasiva","tag-usp","post_format-post-format-video"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/11\/Monitorac%CC%A7a%CC%83o-NAVE.jpg?fit=1920%2C1080&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1138","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/comments?post=1138"}],"version-history":[{"count":12,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1138\/revisions"}],"predecessor-version":[{"id":3420,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/1138\/revisions\/3420"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media\/1345"}],"wp:attachment":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media?parent=1138"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/categories?post=1138"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/tags?post=1138"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}