Bloqueio bilateral do nervo pudendo em gatos com obstrução uretral: relato de oito casos.

Abstract

Cats that have urethral obstruction usually manifest associated with the bladder, cystitis and urethritis distension pain, urethral obstruction and one of the first measures to be taken. Since these patients may have hemodynamic changes indication to the use of some anesthesiologic protocols, improved anesthetic management in these patients is critical to the success of the emergency unblocking pipes. Because the pudendal nerve is responsible for the somatic innervation of the urethra, interrupting its nerve conduction provides relaxation of the external urethral sphincter and analgesia, thus enabling the completion of penile massage and urethral sounding with minimal discomfort to the animal. The absence of published studies, however, that prove the effectiveness of their anesthetic block for this purpose and the clinical importance of such research justify the conduct of the same. Cats originating from routine clinical care Veterinary Hospital/UFCG, with a history of polyuria or anuria, whose physical examination were used to identify compatible with lower urinary tract disease framework, which would be submitted to urethral sounding. They underwent pain evaluation at the time of pre-anesthetic evaluation (M1) and ten (10) minutes after the administration of lidocaine (M2). In cases where it was necessary to repeat the anesthetic block, a new evaluation was performed ten (10) minutes after the second administration of lidocaine (M3) following the Multidimensional Scale for Rating Consisting of Postoperative Pain in Cats adapted from Brondani et al. (2013). After this the animals underwent bilateral pudendal nerve perineural anesthesia with lidocaine with adrenaline (epinephrine) at a dose of 0.1 mL/kg/nerve, those who present themselves anxious or aggressive, or they did not permit the completion of perineural anesthesia underwent tranquilization with acepromazine (0.05 mg/kg) intramuscularly and, when necessary, sedated with tiletamine + zolazepam (Zoletil®) at a dose of 5 mg/kg intramuscularly. The deposition of the local anesthetic was performed bilaterally between the cranial and middle third of the distance between the line drawn between the dorsal region of the iliac crest and the caudal region of the ischial tuberosity, the needle is inserted at an angle of 90º with the line above and 45º with the sagittal plane. Bilateral pudendal nerve block analgesia promoted and sufficient muscle relaxation to allow probing of cats with urethral obstruction with maximum safety and minimal discomfort as possible.