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Efficacy of the Parasympathetic Tone Activity monitor to assess nociception in healthy dogs anaesthetized with propofol and sevoflurane

Published:August 27, 2019DOI:https://doi.org/10.1016/j.vaa.2019.05.014

      Abstract

      Objective

      To compare a Parasympathetic Tone Activity (PTA) monitor with cardiovascular changes in invasive mean arterial pressure (IMAP) and heart rate (HR) when evaluating the response to nociceptive stimuli in anaesthetized dogs.

      Study design

      Prospective experimental study.

      Animals

      A group of nine (seven male and two female) adult Beagle dogs weighing 13.4 ± 1.5 kg (mean ± standard deviation).

      Methods

      Anaesthesia was induced with propofol and maintained with sevoflurane in oxygen. Electrical stimuli of different nociceptive intensities were applied for 30 seconds. Stimuli were classified in each patient according to the response obtained (relevant change ≥ 20%) as low (no response), medium (PTA only) or high (PTA and IMAP/HR). Immediate and averaged values of PTA, IMAP and HR were recorded every second from 60 seconds before to 120 seconds after application of the nociceptive stimulus. Time to nociceptive response and peak response were evaluated with analysis of variance and t test.

      Results

      Immediate PTA baseline values did not differ significantly before application of the low, medium and high stimuli (73 ± 15, p = 0.966). Immediate PTA response was observed with the medium stimulus at 33 ± 7 seconds with a maximum decrease of 57 ± 13% at 69 ± 5 seconds. With the high stimulus, the immediate PTA response was of a similar magnitude to the medium stimulus with a response at 28 ± 7 seconds (p = 0.221) and a maximum decrease of 68 ± 15% (p = 0.115) at 72 ± 7 seconds (p = 0.436). The cardiovascular change occurred (22 ± 8 seconds) prior to the immediate PTA response (p = 0.032).

      Conclusions and clinical relevance

      The PTA monitor detected nociceptive stimuli at lower intensities than those eliciting cardiovascular changes. However, nociceptive stimuli of higher intensities provoked cardiovascular changes that occurred before a PTA response was observed.

      Keywords

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      References

        • Boselli E.
        • Bouvet L.
        • Begou G.
        • et al.
        Prediction of immediate postoperative pain using the analgesia/nociception index: a prospective observational study.
        Br J Anaesth. 2014; 112: 715-721
        • Boselli E.
        • Bouvet L.
        • Begou G.
        • et al.
        Prediction of hemodynamic reactivity during total intravenous anesthesia for suspension laryngoscopy using Analgesia/Nociception Index (ANI): a prospective observational study.
        Minerva Anestesiol. 2015; 81: 288-297
        • Boselli E.
        • Logier R.
        • Bouvet L.
        • Allaouchiche B.
        Prediction of hemodynamic reactivity using dynamic variations of Analgesia/Nociception Index (ANI).
        J Clin Monit Comput. 2016; 30: 977-984
        • Citak Karakaya I.
        • Karakaya M.G.
        • Ergun E.
        • et al.
        Effects of different frequencies of conventional transcutaneous electrical nerve stimulation on pressure pain threshold and tolerance.
        J Back Musculoskelet Rehabil. 2014; 27: 197-201
        • Doxey S.
        • Boswood A.
        Differences between breeds of dog in a measure of heart rate variability.
        Vet Rec. 2004; 154: 713-717
        • Gruenewald M.
        • Ilies C.
        • Herz J.
        • et al.
        Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol-remifentanil anaesthesia.
        Br J Anaesth. 2013; 110: 1024-1030
        • Gutierrez-Blanco E.
        • Victoria-Mora J.M.
        • Ibancovichi-Camarillo J.A.
        • et al.
        Evaluation of the isoflurane-sparing effects of fentanyl, lidocaine, ketamine, dexmedetomidine, or the combination lidocaine-ketamine-dexmedetomidine during ovariohysterectomy in dogs.
        Vet Anaesth Analg. 2013; 40: 599-609
        • Jeanne M.
        • Delecroix M.
        • De Jonckheere J.
        • et al.
        Variations of the analgesia nociception index during propofol anesthesia for total knee replacement.
        Clin J Pain. 2014; 30: 1084-1088
        • Jeanne M.
        • Logier R.
        • De Jonckheere J.
        • Tavernier B.
        Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia.
        Conf Proc IEEE Eng Med Biol Soc. 2009; 2009: 1840-1843
        • Lardone E.
        • Peirone B.
        • Adami C.
        Combination of magnesium sulphate and ropivacaine epidural analgesia for hip arthroplasty in dogs.
        Vet Anaesth Analg. 2017; 44: 1227-1235
        • Lena P.
        • Balarac N.
        • Lena D.
        • et al.
        Fast-track anesthesia with remifentanil and spinal analgesia for cardiac surgery: the effect on pain control and quality of recovery.
        J Cardiothorac Vasc Anesth. 2008; 22: 536-542
        • Logier R.
        • Jeanne M.
        • De Jonckheere J.
        • et al.
        PhysioDoloris: a monitoring device for analgesia / nociception balance evaluation using heart rate variability analysis.
        Conf Proc IEEE Eng Med Biol Soc. 2010; 2010: 1194-1197
        • Mansour C.
        • Merlin T.
        • Bonnet-Garin J.M.
        • et al.
        Evaluation of the Parasympathetic Tone Activity (PTA) index to assess the analgesia/nociception balance in anaesthetised dogs.
        Res Vet Sci. 2017; 115: 271-277
        • Popping D.M.
        • Elia N.
        • Van Aken H.K.
        • et al.
        Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials.
        Ann Surg. 2014; 259: 1056-1067
        • Poyhonen M.
        • Syvaoja S.
        • Hartikainen J.
        • et al.
        The effect of carbon dioxide, respiratory rate and tidal volume on human heart rate variability.
        Acta Anaesthesiol Scand. 2004; 48: 93-101
        • Reddi D.
        • Curran N.
        Chronic pain after surgery: pathophysiology, risk factors and prevention.
        Postgrad Med J. 2014; 90: 222-227
        • Sato K.L.
        • Sanada L.S.
        • Rakel B.A.
        • Sluka K.A.
        Increasing intensity of TENS prevents analgesic tolerance in rats.
        J Pain. 2012; 13: 884-890
        • van Ravenswaaij-Arts C.M.
        • Kollee L.A.
        • Hopman J.C.
        • et al.
        Heart rate variability.
        Ann Intern Med. 1993; 118: 436-447
        • Voigt A.M.
        • Bergfeld C.
        • Beyerbach M.
        • Kästner S.B.
        Effects of isoflurane with and without dexmedetomidine or remifentanil on heart rate variability before and after nociceptive stimulation at different multiples of minimum alveolar concentration in dogs.
        Am J Vet Res. 2013; 74: 665-671