Université de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Service d'Anesthésie, Marcy l'Etoile, France.
Université de Lyon, Hospices Civiles de Lyon, Centre Hospitalier Lyon Sud, Réanimation Médicale, Unité APCSE, Pierre-Bénite, France.
Vet Anaesth Analg. 2022 Nov;49(6):597-607. doi: 10.1016/j.vaa.2022.08.009. Epub 2022 Aug 30.
To evaluate the performance of the Parasympathetic Tone Activity (PTA) index in assessing the nociception-antinociception balance in anaesthetized dogs undergoing castration.
Prospective clinical study.
A group of 22 healthy client-owned dogs.
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.
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%).
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.
评估副交感神经张力活动（PTA）指数在评估接受去势麻醉犬的伤害感受-抗伤害感受平衡中的表现。
前瞻性临床研究。
一组 22 只健康的客户拥有的狗。
狗接受全身麻醉，连续监测平均和瞬时 PTA（PTAm，PTAi）、平均动脉压和心率。这些变量的值根据不同时间点是否发生血流动力学反应（HDR）进行划分：手术准备期间、皮肤切口、睾丸提取、皮肤缝合、芬太尼给药后、恢复期间给予右美托咪定后。最初收集数据，并在每个时间点后 1、3 和 5 分钟收集数据。使用接收者操作特征（ROC）曲线分析评估 PTA 动态变化（ΔPTA）预测 3 或 5 分钟内 HDR 或其缓解的性能。p 值<0.05 被认为具有统计学意义。
在 HDR 期间，PTAi（-34% 和-31%）和 PTAm（-26% 和-30%）在 3 分钟（p=0.005；p=0.004）和 5 分钟（p=0.001）时降低。芬太尼给药后，血流动力学变量下降，PTAi 增加 45%（p=0.004）。对预测 3 分钟内 HDR 的 ΔPTAi 进行汇总数据分析的 ROC 曲线分析表明曲线下面积（AUC）为 0.70（p=0.0016）（阈值：-16%）。芬太尼给药后，预测 3 分钟内 HDR 缓解的 ΔPTAi 的 ROC 曲线分析表明 AUC 为 0.69（阈值：+12%）。
PTAi 似乎是评估伤害感受-抗伤害感受平衡的一种有趣工具。然而，需要进行更多具有各种临床情况和麻醉方案的研究，以得出其性能结论。
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