MANEJO INTENSIVO E ANESTÉSICO DE FELINO SUBMETIDO A REDUÇÃO DE HÉRNIA DIAFRAGMÁTICA TRAUMÁTICA

Abstract

Traumatic diaphragmatic hernia is a condition frequently observed in veterinary emergency medicine, resulting from high-energy trauma that causes rupture of the diaphragm and displacement of abdominal organs into the thoracic cavity. This condition can severely compromise pulmonary ventilation and hemodynamic stability, requiring rapid diagnosis and appropriate surgical intervention. This report describes the case of a cat treated after being hit by a car, stable but presenting pain in the epigastric region, with the diagnosis of diaphragmatic hernia confirmed by imaging tests. After initial clinical stabilization and laboratory tests for systemic evaluation, the animal was referred for diaphragmatic repair surgery. The anesthesia used combined general and regional techniques, including intravenous induction and maintenance with total intravenous anesthesia associated with protective mechanical ventilation, in addition to performing transverse abdominal plane block (conventional and subcostal TAP block) with bupivacaine, aiming at effective analgesia and reduction in the use of systemic opioids. The surgical approach was performed by median laparotomy, with repositioning of the herniated viscera followed by herniorrhaphy, and the patient was transferred to the ICU for intensive postoperative monitoring and multimodal analgesia. Despite adequate anesthetic and surgical management, the patient presented progressive respiratory deterioration in the immediate postoperative period and died of cardiorespiratory arrest. This report reinforces the challenges involved in the treatment of traumatic diaphragmatic hernias and describes preoperative stabilization, individualized anesthetic planning, and rigorous postoperative monitoring. In addition, it highlights the role of regional analgesic techniques as tools for patient comfort.