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犬异丙酚序贯靶控输注期间麻醉深度和脑电双频指数的评估

Evaluation of the anesthetic depth and bispectral index during propofol sequential target-controlled infusion in dogs.

作者信息

Ubiali Matheus Luis Cunha, Meirelles Guilherme Paes, Vilani Julia Milczewski, da Luz Henrique Erick, Marangoni Sabrine, Rodrigues Raisa Braul, Vilani Ricardo Guilherme D'OCtaviano de Castro

机构信息

Department of Veterinary Sciences Graduation, Agricultural Sciences Sector, Federal University of Paraná, Curitiba, Brazil.

出版信息

Vet World. 2022 Mar;15(3):537-542. doi: 10.14202/vetworld.2022.537-542. Epub 2022 Mar 8.

Abstract

BACKGROUND AND AIM

The use of anesthetic infusions based on pharmacokinetic values associated with anesthetic plan and bispectral index in dogs have not been well-documented in the literature. This study aimed to evaluate the bispectral index (BIS) change based on pre-propofol and establish clinical anesthetic depth changes during propofol sequential target-controlled infusion (STCI) in dogs with a plasma target of 5 μg/mL.

MATERIALS AND METHODS

Twenty healthy male dogs aged 1-3 years and weighing 9.8-44 kg were recruited. These dogs were pre-medicated intramuscularly with methadone (0.2 mg/kg) and acepromazine (0.03 mg/kg). After 30 min, propofol anesthetic induction and maintenance were initiated using STCI according to dog pharmacokinetic (PK) parameters. Subsequently, the target plasma concentration of propofol was set at 5 μg/mL for both anesthetic induction and the 120 min maintenance. Then, TivaTrainer v.9.1 software was used to calculate anesthetic infusion rates in a TCI plasmatic concentration mode using the PKs model optimized by covariates for propofol TCI in dogs. The BIS value was recorded every 5 min from the beginning of induction until the end of anesthesia. Finally, analysis of variance was performed on numerical data using the Friedman test, followed by the Bonferroni adjustment (p<0.05).

RESULTS

A statistical difference was observed between the baseline BIS value (T0), with a median value of 84.5 (81-97), and BIS after every 15 min (T15) of inducing anesthesia. Surgical anesthetic depth was also reached in 18 of 20 dogs after 10 min of infusion and in all dogs after 20 min, with a median BIS value of 72 (53-89) at the time of surgical anesthesia depth. Results also showed no BIS variation (p<0.05) between anesthetic moments after anesthetic induction with a substantial amplitude of BIS in the surgical anesthetic depth. Moreover, the maximum depth of anesthesia in all dogs by clinical evaluation was reached after 20 min of anesthesia and then remained stable throughout the anesthetic period.

CONCLUSION

This study suggested that most dogs (90%) attained a surgical depth of anesthesia within 15 min of STCI onset, with a plasma target of 5 μg/mL and no change in anesthetic depth throughout the period anesthesia lasted. Furthermore, median BIS values remained high even after dogs reached the surgical depth of anesthesia, indicating that the comparison of BIS values of dogs and humans should not be considered for classifying anesthetic and hypnotic depths in dogs.

摘要

背景与目的

基于与麻醉方案相关的药代动力学值及双谱指数在犬类中使用麻醉输注的情况,在文献中尚未得到充分记载。本研究旨在评估基于异丙酚给药前的双谱指数(BIS)变化,并确定血浆靶浓度为5μg/mL的犬类在异丙酚序贯靶控输注(STCI)过程中的临床麻醉深度变化。

材料与方法

招募了20只年龄在1至3岁、体重9.8至44千克的健康雄性犬。这些犬经肌肉注射美沙酮(0.2mg/kg)和乙酰丙嗪(0.03mg/kg)进行术前用药。30分钟后,根据犬类药代动力学(PK)参数,使用STCI开始异丙酚麻醉诱导和维持。随后,将异丙酚的靶血浆浓度设定为5μg/mL用于麻醉诱导和120分钟的维持。然后,使用TivaTrainer v.9.1软件,以犬类异丙酚TCI的协变量优化PKs模型,在TCI血浆浓度模式下计算麻醉输注速率。从诱导开始至麻醉结束,每5分钟记录一次BIS值。最后,使用Friedman检验对数值数据进行方差分析,随后进行Bonferroni校正(p<0.05)。

结果

观察到基线BIS值(T0)的中位数为84.5(81 - 97)与麻醉诱导后每15分钟(T15)的BIS值之间存在统计学差异。20只犬中有18只在输注10分钟后达到手术麻醉深度,20分钟后所有犬均达到,手术麻醉深度时BIS值的中位数为72(53 - 89)。结果还显示,麻醉诱导后各麻醉时刻之间BIS无变化(p<0.05),在手术麻醉深度时BIS有较大幅度变化。此外,通过临床评估,所有犬在麻醉20分钟后达到最大麻醉深度,然后在整个麻醉期间保持稳定。

结论

本研究表明,大多数犬(90%)在STCI开始后15分钟内达到手术麻醉深度,血浆靶浓度为5μg/mL,且在整个麻醉持续期间麻醉深度无变化。此外,即使犬达到手术麻醉深度后,BIS值的中位数仍保持较高,这表明在对犬类的麻醉和催眠深度进行分类时,不应考虑犬与人BIS值的比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dec/9047143/499e80d01ec8/Vetworld-15-537-g001.jpg

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