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

Aguado, Delia; Bustamante, Rocío; García-Sanz, Virginia; González-Blanco, Paula; Segura, Ignacio A. Gómez de

doi:10.1016/j.vaa.2019.05.014

Cited by 18 publications

(27 citation statements)

References 17 publications

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“…The Parasympathetic Tone Activity (PTA) monitor is a version of ANI monitor, the first of a kind in veterinary medicine. The operating principle of this monitor has been described previously [16,17,20,21]. In brief, it detects heart rate variability (HRV) and gives an 'immediate' and 'averaged' index.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses

Dmitrović

Vanaga

Dupont

et al. 2021

Animals

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Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesia. A further 11 horses in the control group (Group C) received equivalent volumes of normal saline. Anaesthetic parameters and PTA index were recorded during anaesthesia. The achieved mean fentanyl plasma concentration was 6.2 ± 0.83 ng/mL. No statistically significant differences between groups were found in isoflurane requirements, MAP values, and mean dobutamine requirements. However, horses in Group F required a significantly lower dose of additional ketamine to maintain a sufficient depth of anaesthesia. Significantly higher PTA values were found in the fentanyl group. Further research is warranted to determine the limitations of PTA monitoring, and the influence of various anaesthetics on its values.

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Section: Introductionmentioning

confidence: 99%

“…The PTA monitor may help to optimize patient status during anaesthesia and guide the decision of additional analgesia administration. It may also help to evaluate the effects of a particular analgesic drug used during surgery [16,21].…”

Section: Introductionmentioning

confidence: 99%

Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses

Dmitrović

Vanaga

Dupont

et al. 2021

Animals

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“…Recently, Aguado et al (1) applied electrical nociceptive stimuli of different intensities to research dogs and demonstrated that at low intensity, the PTA monitor was able to detect nociceptive responses before cardiovascular changes in HR and mean arterial pressure were elicited. In our study, the PTA values were not significantly different between baselines or between treatments and HR and HRV ranges measured in the PTA monitor were within normal ranges.…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been implemented to quantify the nociception-antinociception balance in the anaesthetised patient in a more reliable way, e.g. the analysis of reflex pathways, pulse photoplethysmography, skin vasomotor reflexes via laser Doppler flowmetry, pupillometry, cerebral evoked potentials, and heart rate variability (HRV) (1,5,7,11,12). In human anaesthesiology, the analgaesia-nociception index (ANI), a recent development derived from HRV, has been validated for intraoperative nociception detection (3,5,8,15,24), as it reflects the relative parasympathetic tone (11).…”

Section: Introductionmentioning

confidence: 99%

Clinical use of the parasympathetic tone activity index as a measurement of postoperative analgaesia in dogs undergoing ovariohysterectomy

Hernández-Ávalos

Valverde

Ibancovichi-Camarillo³

et al. 2021

Journal of Veterinary Research

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Introduction While the current tools to assess canine postoperative pain using physiological and behavioural parameters are reliable, an objective method such as the parasympathetic tone activity (PTA) index could improve postoperative care. The aim of the study was to determine the utility of the PTA index in assessing postoperative analgaesia. Material and Methods Thirty healthy bitches of different breeds were randomly allocated into three groups for analgaesic treatment: the paracetamol group (GPARAC, n = 10) received 15 mg/kg b.w., the carprofen group (GCARP, n = 10) 4 mg/kg b.w., and the meloxicam group (GMELOX, n = 10) 0.2 mg/kg b.w. for 48 h after surgery. GPARAC was medicated orally every 8 h, while GCARP and GMELOX were medicated intravenously every 24 h. The PTA index was used to measure the analgaesia–nociception balance 1 h before surgery (baseline), and at 1, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 h after, at which times evaluation on the University of Melbourne Pain Scale (UMPS) was made. Results The baseline PTA index was 65 ± 8 for GPARAC, 65 ± 7 for GCARP, and 62 ± 5 for GMELOX. Postoperatively, it was 65 ± 9 for GPARAC, 63 ± 8 for GCARP, and 65 ± 8 for GMELOX. No statistically significant difference existed between baseline values or between values directly after treatments (P = 0.99 and P = 0.97, respectively). The PTA index showed a sensitivity of 40%, specificity of 98.46% and a negative predictive value of 99.07%. Conclusion Our findings suggest that the PTA index measures comfort and postoperative analgaesia objectively, since it showed a clinical relationship with the UMPS.

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“…A clinical study showed that a dynamic variation of PTA (ΔPTA) of −18% can predict changes within 5 min in the vital parameters during general anaesthesia in dogs using morphine in premedication [9]. In addition, a recent experimental study comparing the PTA monitor with cardiovascular changes in healthy dogs revealed that PTA index could be more efficient in detecting low intensity nociceptive stimuli than those eliciting cardiovascular changes [10].…”

Section: Introductionmentioning

confidence: 99%

Performance of the Parasympathetic Tone Activity (PTA) index to assess the intraoperative nociception using different premedication drugs in anaesthetised dogs

Mansour

Hachem

Jamous

et al. 2020

International Journal of Veterinary Science and Medicine

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The dynamic variations of the Parasympathetic Tone Activity (PTA) index were evaluated to assess nociception in dogs undergoing anaesthetic protocols with different premedication drugs. Sixty-six dogs, divided into three groups of 22 dogs each, were given different premedication drugs "morphine" (0.2 mg/kg), "morphine + medetomidine (5 μg/kg)", "morphine + acepromazine (0.03 mg/kg)", then similarly induced and maintained under general anaesthesia. The PTA, HR (heart rate) and MAP (mean arterial pressure) were assessed at S (steady-state), Cut (cutaneous incision), PTA E (PTA Event, assessed 1 min before a significant PTA decrease), HDR (Haemodynamic reaction, assessed 5 min before an increase of ≥ 20% in HR and/or MAP). For each group, the dynamic variation of PTA (ΔPTA) was calculated and a Receiver Operating Characteristics (ROC) curve was performed to detect if any of the premedication drugs may alter the performance of PTA index to predict intraoperative haemodynamic reactions. In all groups, a haemodynamic reaction was detected after Cut, PTA E and HDR and was preceded with a significant decrease of PTA, except for "morphine + medetomidine" group which showed a significant drop of PTA only at PTA E and HDR. The ΔPTA showed a fair performance in all groups (a mean [95%

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

Cited by 18 publications

References 17 publications

Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses

Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses

Clinical use of the parasympathetic tone activity index as a measurement of postoperative analgaesia in dogs undergoing ovariohysterectomy

Performance of the Parasympathetic Tone Activity (PTA) index to assess the intraoperative nociception using different premedication drugs in anaesthetised dogs

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