Multimodal anesthesia associated with regional block in a dog who underwent corrective surgery for persistent right aortic arch: case report

Abstract

The persistence of the fourth right aortic arch (PRAA) is a congenital malformation that affects the heart base's main vessels. Surgical treatment is recommended and should be advocated as a matter of urgency. In this context, efficient anesthesia planning is necessary, with satisfactory analgesia, associating multimodal techniques with regional blocks. The present work aims to report the anesthetic procedure during corrective surgery for PRAA in a dog. Neuroleptanalgesia was intramuscularly performed, using acepromazine (0.015 mg.kg-¹) and methadone (0.3 mg.kg-¹) in pre-anesthetic medication. Ketamine (1 mg.kg^-1) and propofol (3 mg.kg^-1) were administered at induction, both intravenously, followed by maintenance using total intravenous anesthesia with propofol (initial rate of 0.4 mg.kg^-1 .minute) and remifentanil, (0.2 mcg.kg.^-1.minute). In addition, ultrasound-guided regional intercostal block was performed, with 5% bupivacaine without vasoconstrictor (0.05ml.kg^-1). Ketamine infusion was postoperatively maintained for one hour. The instituted protocol proved to be satisfactory in controlling trans and postoperative pain, maintaining all parameters stable during and after the procedure, without any intercurrence. Thus, the protocol provided quality recovery to the patient.