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

Voigt, Anne; Bergfeld, C.; Beyerbach, Martin; Kästner, Sabine

doi:10.2460/ajvr.74.5.665

Cited by 10 publications

(13 citation statements)

References 38 publications

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“…Anesthesia was essential for this study, both to be able to undertake the surgical interventions and to reduce movement artefact during HRV assessment, but is also known to profoundly alter autonomic regulation. However, lower concentrations of isoflurane, such as in the current study, have been reported to induce a reflex increase in sympathetic tone [ 47 ], which may be considered further support to the findings in the current study that the C5aR is required for maximal responsiveness in the β1-AR. Furthermore, it should be recognized that HRV only provides a very indirect marker of autonomic regulation.…”

Section: Discussionsupporting

confidence: 88%

A Potential Link between the C5a Receptor 1 and the β1-Adrenoreceptor in the Mouse Heart

et al. 2016

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PurposeInflammation may contribute to the pathogenesis of specific cardiovascular diseases, but it is uncertain if mediators released during the inflammatory process will affect the continued efficacy of drugs used to treat clinical signs of the cardiac disease. We investigated the role of the complement 5a receptor 1 (C5aR1/CD88) in the cardiac response to inflammation or atenolol, and the effect of C5aR1 deletion in control of baseline heart rate in an anesthetized mouse model.MethodsAn initial study showed that PMX53, an antagonist of C5aR1 in normal C57BL6/J (wild type, WT) mice reduced heart rate (HR) and appeared to have a protective effect on the heart following induced sepsis. C5aR1 knockout (CD88-/-) mice had a lower HR than wild type mice, even during sham surgery. A model to assess heart rate variability (HRV) in anesthetized mice was developed to assess the effects of inhibiting the β1-adrenoreceptor (β1-AR) in a randomized crossover study design.ResultsHR and LF Norm were constitutively lower and SDNN and HF Norm constitutively higher in the CD88-/- compared with WT mice (P< 0.001 for all outcomes). Administration of atenolol (2.5 mg/kg) reduced the HR and increased HRV (P< 0.05, respectively) in the wild type but not in the CD88-/- mice. There was no shift of the sympathovagal balance post-atenolol in either strains of mice (P> 0.05), except for the reduced LF/HF (Lower frequency/High frequency) ratio (P< 0.05) at 60 min post-atenolol, suggesting increased parasympathetic tone of the heart due to the effect of atenolol administration. The HR of the WT mice were lower post atenolol compared to the CD88-/- mice (P = 0.001) but the HRV of CD88-/- mice were significantly increased (P< 0.05), compared with WT mice.ConclusionKnockout of the C5aR1 attenuated the effect of β1-AR in the heart, suggesting an association between the β1-AR and C5aR1, although further investigation is required to determine if this is a direct or causal association.

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Section: Discussionsupporting

confidence: 88%

A Potential Link between the C5a Receptor 1 and the β1-Adrenoreceptor in the Mouse Heart

et al. 2016

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“…This finding corresponds to the findings from studies on other species. An epidural administration of dexmedetomidine was able to reduce the isoflurane requirements up to 33% in dogs [25], and a CRI of dexmedetomidine in dogs at the same rate as in the present study had a MAC-sparing effect between 41% [26] and 59% [27]. In cats, pharmacokinetic studies have shown a dose-dependent reduction in isoflurane requirements with an estimated maximal sparing effect of approximately 80% [28].…”

Section: Discussionmentioning

confidence: 73%

Experimental study on the effects of isoflurane with and without remifentanil or dexmedetomidine on heart rate variability before and after nociceptive stimulation at different MAC multiples in cats

2019

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Background Heart rate variability (HRV) provides information about autonomic nervous system (ANS) activity and is therefore a possible tool with which to assess anaesthetic depth. The aim of the present study was to evaluate the effects of isoflurane, remifentanil and dexmedetomidine on HRV before and after nociceptive stimulation at different anaesthetic depths. Seven healthy domestic short-hair cats were used, and each cat was anaesthetized three times – group I with isoflurane alone, group IR with isoflurane and a constant rate infusion (CRI) of remifentanil (18 μg/kg/h), and group ID with isoflurane and a CRI of dexmedetomidine (3 μg/kg/h). Minimum alveolar concentration (MAC) values were determined via electrical supramaximal nociceptive stimulation for each treatment group. Nociceptive stimulation was repeated at 3 different MAC multiples (0.75, 1.0 and 1.5 MAC), and electrocardiographic recordings were performed for 3 min before and after stimulation. Only the 1 min epochs were used for further statistical analysis. Electrocardiographic data were exported for offline HRV analysis. Results The mean isoflurane MAC ± standard deviation (SD) was 1.83 ± 0.22 vol% in group I, 1.65 ± 0.13 vol% in group IR and 0.82 ± 0.20 vol% in group ID. Nociception was indicated by several HRV parameters, however, with high variability between treatments. The best correlation with MAC was found for the SD of heart rate (STD HR) in group I ( r s = − 0.76, p = 0.0001, r 2 = 0.46). STD HR was also able to distinguish 0.75 MAC from 1.5 MAC and 1.0 MAC from 1.5 MAC in group I, as well as 0.75 MAC from 1.5 MAC in group ID. Conclusions The choice of anaesthetic protocol influences the HRV parameters in cats. Frequency domain parameters respond to nociception at lower MAC levels. The STD HR has the potential to provide additional information for the assessment of anaesthetic depth in isoflurane-anaesthetized cats. The utility of HRV analysis for the assessment of anaesthetic depth in cats is still questionable. Electronic supplementary material The online version of this article (10.1186/s12917-019-2004-8) contains supplementary material, which is available to authorized users.

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“…Furthermore, anaesthesia in the present study was induced with propofol and maintained with sevoflurane. Different results may be obtained using other drugs, especially those affecting HR variability such as atropine, opioids or a 2 -adrenoceptor agonists (Voigt et al 2013).…”

Section: Discussionmentioning

confidence: 99%

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

Aguado

Bustamante

García-Sanz

et al. 2020

Veterinary Anaesthesia and Analgesia

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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

Cited by 10 publications

References 38 publications

A Potential Link between the C5a Receptor 1 and the β1-Adrenoreceptor in the Mouse Heart

A Potential Link between the C5a Receptor 1 and the β1-Adrenoreceptor in the Mouse Heart

Experimental study on the effects of isoflurane with and without remifentanil or dexmedetomidine on heart rate variability before and after nociceptive stimulation at different MAC multiples in cats

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

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