Total intravenous anesthesia for laparoscopic portosystemic shunt repair in a dog - case report

ABSTRACT An anomalous venous communication between the systemic and portal circulations characterizes a portosystemic shunt. Surgery is the gold standard treatment, and the laparoscopic approach is a growing option for correcting these anomalies. The need for pneumoperitoneum, sometimes associated with controlled ventilation, in patients with altered liver function implies a careful choice of anesthetic techniques. Total intravenous anesthesia has favorable characteristics, including independence from alveolar ventilation for anesthetic effects and the possibility of pharmacological associations with favorable metabolic and analgesic profiles. A 2-year-old Pinscher underwent laparoscopic surgery under total intravenous anesthesia for the occlusion of an extrahepatic portosystemic shunt with an ameroid ring constrictor. The drugs of choice for anesthetic maintenance were propofol, remifentanil, and ketamine administered via continuous infusion. Multimodal analgesia has proven to be efficient in reducing the rate of propofol required, providing satisfactory physiological stability during anesthesia, and smooth recovery, without signs of pain, vocalization, or nausea. In conclusion, total intravenous anesthesia was effective for laparoscopic surgery in the treatment of the dog with portosystemic shunt.