Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA.
Am J Vet Res. 2023 May 31;84(7). doi: 10.2460/ajvr.23.03.0050. Print 2023 Jul 1.
To evaluate the effects of rocuronium and sugammadex on the patient state index (PSI) in dogs anesthetized with propofol.
6 intact healthy male Beagles.
Anesthesia was induced with and maintained on a propofol infusion. The estimated plasma propofol concentration (ePC) was recorded. Baseline PSI and train-of-four ratio (TOFR) readings were collected for 2 minutes in stable general anesthesia. Neuromuscular blockade (NMB) was induced with 0.6 mg/kg, IV, rocuronium, and full NMB was confirmed with a TOFR of 0. After 5 minutes, the neuromuscular function was restored with 4 mg/kg sugammadex, IV (reversal), and monitored for 5 minutes. Throughout the data collection, ePC, PSI, and TOFR were recorded every 15 seconds and compared with mixed-effect ANOVA.
Baseline ePC, PSI, and TOFR were 3.63 ± 0.38, 41 ± 6, and 0.97 ± 0.08 µg/mL, respectively. There was no difference between the baseline of ePC and PSI from NMB or reversal. Compared to the baseline, the TOFR decreased to 0 with NMB (P < .001) and returned to 0.96 ± 0.08 (P = .721) on reversal. After 5 minutes, sugammadex fully reversed 5 out of 6 dogs to TOFR > 0.90 and partially reversed 1 animal to TOFR = 0.80.
There was no evidence that NMB with rocuronium and sugammadex-induced reversal interfered with PSI readings under steady-state total intravenous anesthesia with propofol. Further evaluation of PSI is warranted to assess its utility in a clinical population to detect changes in levels of consciousness during NMB.
评估丙泊酚麻醉犬中罗库溴铵和琥珀酸舒更葡糖钠对患者状态指数（PSI）的影响。
6 只完整健康雄性比格犬。
麻醉诱导和维持用丙泊酚输注。记录估计的血浆丙泊酚浓度（ePC）。在稳定的全身麻醉下，收集 2 分钟的基础 PSI 和四脉冲比（TOFR）读数。静脉注射 0.6mg/kg 罗库溴铵诱导神经肌肉阻滞（NMB），TOFR 为 0 时确认完全 NMB。5 分钟后，静脉注射 4mg/kg 琥珀酸舒更葡糖钠（逆转）恢复神经肌肉功能，并监测 5 分钟。在整个数据收集过程中，每 15 秒记录一次 ePC、PSI 和 TOFR，并与混合效应 ANOVA 进行比较。
基础 ePC、PSI 和 TOFR 分别为 3.63±0.38、41±6 和 0.97±0.08µg/mL。NMB 或逆转时，ePC 和 PSI 的基础值之间没有差异。与基线相比，NMB 时 TOFR 降至 0（P<0.001），逆转时恢复至 0.96±0.08（P=0.721）。5 分钟后，琥珀酸舒更葡糖钠完全逆转了 6 只犬中的 5 只，TOFR>0.90，部分逆转了 1 只犬，TOFR=0.80。
没有证据表明罗库溴铵诱导的 NMB 并用琥珀酸舒更葡糖钠逆转会干扰丙泊酚全静脉麻醉下的 PSI 读数。需要进一步评估 PSI，以评估其在临床人群中的效用，以检测 NMB 期间意识水平的变化。
