{"id":737,"date":"2020-06-24T09:00:49","date_gmt":"2020-06-24T12:00:49","guid":{"rendered":"http:\/\/nave.vet.br\/?p=737"},"modified":"2023-02-11T14:00:55","modified_gmt":"2023-02-11T17:00:55","slug":"debito-cardiaco-vs-dex-ou-dex-atropina","status":"publish","type":"post","link":"https:\/\/nave.vet.br\/en\/posts\/debito-cardiaco-vs-dex-ou-dex-atropina\/","title":{"rendered":"Dexmedetomidina vs. Dex\/Atropina no D\u00e9bito Card\u00edaco"},"content":{"rendered":"<div id=\"advads-222747391\" 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-1417484575\"><div id=\"advads-968410157\"><a href=\"http:\/\/nave.vet.br\/en\/contato\/\" aria-label=\"Anuncie-Aqui-1\"><img src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2023\/05\/Anuncie-Aqui-1.jpg?fit=1000%2C137&#038;ssl=1\" alt=\"\"  srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2023\/05\/Anuncie-Aqui-1.jpg?w=1000&ssl=1 1000w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2023\/05\/Anuncie-Aqui-1.jpg?resize=300%2C41&ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2023\/05\/Anuncie-Aqui-1.jpg?resize=768%2C105&ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2023\/05\/Anuncie-Aqui-1.jpg?resize=18%2C2&ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" width=\"1000\" height=\"137\"   \/><\/a><\/div><\/div><\/div>\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?resize=461%2C259\" alt=\"\" class=\"wp-image-744\" width=\"461\" height=\"259\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?resize=1024%2C576&amp;ssl=1 1024w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?resize=768%2C432&amp;ssl=1 768w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?resize=1536%2C864&amp;ssl=1 1536w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?w=1920&amp;ssl=1 1920w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping-1.jpg?w=1600 1600w\" sizes=\"(max-width: 461px) 100vw, 461px\" \/><\/figure>\n\n\n\n<p class=\"translation-block\">Ol\u00e1 Pessoal, tudo bem? Essa discuss\u00e3o est\u00e1 relacionada \u00e0 videoaula de <a href=\"http:\/\/nave.vet.br\/en\/webseries\/basico\/mpa-2-anestesia-e-o-basico\/\" class=\"rank-math-link\" target=\"_self\">MPA \u2013 Agonistas alfa<sub>2<\/sub> adren\u00e9rgicos e anticolin\u00e9rgicos<\/a>, do curso Anestesia \u00e9 o B\u00e1sico.  Nos \u00faltimos 5-10 anos o uso de dexmedetomidina vem crescendo bastante como MPA em c\u00e3es e gatos. Isso se deve principalmente pelo excelente <strong>efeito sedativo<\/strong>, bom efeito <strong>analg\u00e9sico e miorrelaxante<\/strong>; obviamente que o marketing tem contribu\u00eddo muito tamb\u00e9m. Mas faz parte do jogo. Realmente a dex (carinhosamente chamada assim) funciona muito bem, n\u00e3o s\u00f3 em c\u00e3es e gatos como tamb\u00e9m em outras esp\u00e9cies.<\/p>\n\n\n\n<p class=\"translation-block\">Mas, ser\u00e1 que ela \u00e9 boa? SIM!!! Em rela\u00e7\u00e3o a esses aspectos (seda\u00e7\u00e3o, analgesia e miorrelaxamento) ela realmente \u00e9 excelente. O detalhe importante \u00e9 \u201co que ela faz com a fisiologia do paciente\u201d. Ainda que a dex seja o agonista alfa<sub>2<\/sub> adren\u00e9rgico mais seletivo para receptores alfa<sub>2<\/sub>\/alfa<sub>1<\/sub> no momento, as altera\u00e7\u00f5es cardiovasculares tem importante relev\u00e2ncia.  No artigo de Congdon et al, (2011), realizado na Colorado State University, avaliaram qual o impacto de uma dose de 10 \u00b5g\/kg de dex IM promoveria em c\u00e3es, associada ou n\u00e3o \u00e0 atropina.<\/p>\n\n\n\n<p class=\"translation-block\">Independente do tratamento (dex ou dex\/atropina), <strong>a seda\u00e7\u00e3o foi excelente<\/strong> e durou mais de 30 minutos. Tranquilo. <em>A bagun\u00e7a toda ocorreu no sistema cardiovascular<\/em>. A FC diminuiu com a dex e aumentou no grupo dex\/atropina, como j\u00e1 era esperado. Por outro lado, os autores observaram consider\u00e1vel eleva\u00e7\u00e3o da PA (nos dois grupos) e muito maior ainda no grupo dex\/atropina, como podemos ver na figura abaixo. Ok\u2026 podemos pensar que o que queremos \u00e9 PA boa\u2026 <strong>Mas o que \u00e9 PA boa? Hipertens\u00e3o?<\/strong><\/p><div id=\"advads-3871566133\" 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\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.34.37.png?resize=390%2C376\" alt=\"\" class=\"wp-image-739\" width=\"390\" height=\"376\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.34.37.png?w=723&amp;ssl=1 723w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.34.37.png?resize=300%2C290&amp;ssl=1 300w\" sizes=\"(max-width: 390px) 100vw, 390px\" \/><\/figure>\n\n\n\n<p class=\"translation-block\">Agora a bomba vem, em rela\u00e7\u00e3o ao D\u00e9bito Card\u00edaco\u2026 <strong>Queda de 60% no DC<\/strong>! Isso mesmo! Em 15 minutos o volume de sangue bombeado pelo cora\u00e7\u00e3o por minuto caiu 60%. Isso ocorreu principalmente pelo efeito depressor do mioc\u00e1rdio e aumento da resist\u00eancia vascular perif\u00e9rica. Complicado n\u00e9? Press\u00e3o \u201caparentemente boa\u201d\u2026 <em>mas DC p\u00e9ssimo<\/em>. Ressalva\u2026 vamos l\u00e1\u2026 A dose deve ser considerada. Hoje podemos usar 5 \u00b5g\/kg de dex que ainda sim conseguiremos seda\u00e7\u00e3o. Assim, o impacto cardiovascular seria menor. A associa\u00e7\u00e3o com outros medicamentos tamb\u00e9m poderia diminuir esse impacto.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img data-recalc-dims=\"1\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.39.06.png?resize=401%2C357\" alt=\"\" class=\"wp-image-740\" width=\"401\" height=\"357\" srcset=\"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.39.06.png?w=564&amp;ssl=1 564w, https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/Captura-de-Tela-2020-06-24-a%CC%80s-08.39.06.png?resize=300%2C268&amp;ssl=1 300w\" sizes=\"(max-width: 401px) 100vw, 401px\" \/><\/figure>\n\n\n\n<p class=\"translation-block\">Haaa ent\u00e3o n\u00e3o vamos usar dex? N\u00e3o \u00e9 bem assim. Inclusive acho ela muito boa para o que se prop\u00f5e (seda\u00e7\u00e3o, analgesia, miorrelaxamento). Por\u00e9m, temos que ponderar quando utilizar e n\u00e3o sempre utilizar. <br>Esquecemos de discutir sobre a PaO<sub>2<\/sub>\u2026 Mas isso \u00e9 uma outra hist\u00f3ria\u2026 <a href=\"https:\/\/drive.google.com\/file\/d\/1eHg2KrE__gsaehBEPBOfBZuWoaENgT74\/view?usp=sharing\" class=\"rank-math-link\" target=\"_self\" rel=\"noopener\">ou vai l\u00e1 e leia o artigo!<\/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\/basico\/mpa-2-anestesia-e-o-basico\/\">Premedication - Alpha 2 agonists and anticholinergics<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/posts\/caes-e-gatos\/infusao-continua-em-caes-alfa2\/\">Analgesia por infus\u00e3o cont\u00ednua em c\u00e3es \u2013 Agonistas alfa-2 adren\u00e9rgicos<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/nave.vet.br\/en\/posts\/ate-onde-vai-a-analgesia-do-tramadol\/\">At\u00e9 onde vai a analgesia do Tramadol?<\/a><\/li>\n<\/ul>\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>Nos \u00faltimos 5-10 anos o uso de dexmedetomidina vem crescendo bastante como MPA em c\u00e3es e gatos. Isso se deve principalmente pelo excelente efeito sedativo, bom efeito analg\u00e9sico e miorrelaxamento. Mas, ser\u00e1 que ela \u00e9 boa?<\/p>","protected":false},"author":2,"featured_media":743,"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":[3,143],"tags":[73,18,27,78,81,74,75,67,124,69,66,68,71],"class_list":["post-737","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-posts","category-caes-e-gatos","tag-agonistas-alfa-2-adrenergicos","tag-anestesia","tag-anestesia-e-o-basico","tag-atropina","tag-atropine","tag-dexmedetomidina","tag-dexmedetomidine","tag-medicacao-pre-anestesica","tag-monitoracao","tag-premedicacion-anestesica","tag-premedication-anesthesia","tag-sedacao","tag-sedation","post_format-post-format-video"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/nave.vet.br\/wp-content\/uploads\/2020\/06\/dog-sleeping.jpg?fit=1920%2C1080&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/737","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=737"}],"version-history":[{"count":6,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/737\/revisions"}],"predecessor-version":[{"id":2983,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/posts\/737\/revisions\/2983"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media\/743"}],"wp:attachment":[{"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/media?parent=737"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/categories?post=737"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nave.vet.br\/en\/wp-json\/wp\/v2\/tags?post=737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}