ANESTESIA EM PACIENTE ASA IV COM ADENOCARCINOMA SUBMETIDO A LOBECTOMIA PULMONAR: RELATO DE CASO

Performing thoracic surgeries presents significant challenges for both the surgeon and the anesthetist, especially with regard to patient safety and comfort during the trans- and postoperative periods. Anesthetic agents can significantly impact cardiorespiratory function, increasing the risk of complications. The present study aims to report the anesthetic protocol performed on a 9-year-old mixed breed dog (SRD), classified as an ASA IV patient, diagnosed with pulmonary adenocarcinoma in the left cranial lobe, submitted to lobectomy. Clinically, the patient presented episodes of coughing and hemoptysis, emesis, anorexia, apathy and dyspnea. The physical examination revealed non-quantifiable tachypnea, CT of 40ºC, HR of 70bpm, SBP of 100 mmHg, pale mucous membranes, TPC of 3 seconds and dehydration greater than 5%. Pre-anesthetic medication consisted of the administration of methadone (IM), followed by anesthetic induction with fentanyl and propofol (IV). Anesthesia was maintained with inhaled isoflurane associated with a continuous infusion of propofol and remifentanil. Although the patient died a few hours after the procedure, the anesthetic protocol was effective in maintaining clinical stability during the operation and immediate postoperative period.