Abstract
Objective
To evaluate the performance of the Parasympathetic Tone Activity (PTA) index in assessing
the nociception–antinociception balance in anaesthetized dogs undergoing castration.
Study design
Prospective clinical study.
Animals
A group of 22 healthy client-owned dogs.
Methods
The dogs underwent general anaesthesia, with continuous monitoring of mean and instantaneous
PTA (PTAm, PTAi), mean arterial pressure and heart rate. The values of these variables
were divided according to the occurrence or absence of a haemodynamic reaction (HDR)
at different time points: during surgical preparation, cutaneous incision, testicles
extraction, cutaneous suture, after fentanyl administration, and after dexmedetomidine
administration during recovery. Data were collected initially and 1, 3 and 5 minutes
after each time point. The performance of the dynamic variation of the PTA (ΔPTA)
to predict HDR or its resolution within 3 or 5 minutes was assessed using receiver
operating characteristic (ROC) curves analysis. A p value < 0.05 was considered significant.
Results
During HDR, a decrease in PTAi (–34% and –31%) and PTAm (–26% and –30%) occurred at
3 (p = 0.005; p = 0.004) and 5 minutes (p = 0.001), respectively. After fentanyl administration, a decrease in haemodynamic
variables occurred with a 45% increase in PTAi (p = 0.004). The ROC curve analysis of pooled data of the ΔPTAi for the prediction of
HDR within 3 minutes indicated an area under the curve (AUC) of 0.70 (p = 0.0016) (threshold value: –16%). After fentanyl administration, the ROC curve analysis
of ΔPTAi for the prediction of resolution of HDR within 3 minutes indicated an AUC
of 0.69 (threshold value: +12%).
Conclusions and clinical relevance
The PTAi appears to be an interesting tool to assess the nociception–antinociception
balance. However, further studies with a variety of clinical scenarios and anaesthesia
protocols are required to conclude on its performance.
Keywords
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Article info
Publication history
Published online: August 30, 2022
Accepted:
August 22,
2022
Received in revised form:
July 9,
2022
Received:
September 5,
2021
Identification
Copyright
© 2022 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
