Lima Leonor, Dos-Santos José Diogo, Ribeiro Lénio, Cabral Patrícia, Colaço Bruno, Martins João
Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal.
Veterinary and Animal Science Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University-Lisbon University Center, 1749-024 Lisbon, Portugal.
Vet Sci. 2024 Mar 6;11(3):121. doi: 10.3390/vetsci11030121.
The monitoring of nociception/antinociception poses a significant challenge during anesthesia, making the incorporation of new tools like the Parasympathetic Tone Activity (PTA) monitor an added value in feline anesthesia.
To compare the effectiveness and speed of PTA monitoring when compared to heart rate (HR) in detecting surgical stimuli (SS) during the intraoperative period in 49 female cats undergoing ovariectomy (OV).
Instantaneous Parasympathetic Tone Activity (PTAi) values, HR, , and non-invasive SAP and MAP were continuously monitored and systematically assessed. The time required for HR (HR time) and PTAi (PTAi time) to reach their minimum peak values following each surgical stimulus was collected at five points for each anaesthetized cat. Each collected surgical stimulus was categorized into 3 groups for statistical analysis: no nociception detection, no hemodynamic reaction and a PTAi > 50 (); no hemodynamic reaction and a PTAi < 50 ( < 50); and hemodynamic reaction and PTAi < 50 ( < 50).
PTAi response demonstrated effectiveness in detecting nociception compared to HR. The SS were categorized as 36.1% in the group, 50% in the < 50 group, and only 13.9% in the < 50 group. In the < 50 group, PTAi time and HR time had similar speeds in detecting the SS ( = 0.821); however, PTA time was significantly slower in the < 50 group when compared to the < 50 group ( = 0.001).
PTA monitoring may be a useful tool to complement HR monitoring for detecting nociception. PTA monitoring demonstrated a superior diagnostic value compared to HR for detecting nociception in cats undergoing OV and a similar speed to HR in detecting SS when HR increases above 20%. Future studies are needed to understand in a clinical setting the meaning of sympathetic activation/nociception detected using the PTA monitor when the HR increase is not clinically relevant.
在麻醉期间，伤害感受/抗伤害感受的监测面临重大挑战，因此将诸如副交感神经张力活动（PTA）监测仪等新工具纳入猫科动物麻醉具有附加价值。
比较49只接受卵巢切除术（OV）的雌性猫在手术期间，与心率（HR）相比，PTA监测在检测手术刺激（SS）时的有效性和速度。
持续监测并系统评估瞬时副交感神经张力活动（PTAi）值、HR、无创收缩压（SAP）和平均动脉压（MAP）。在每只麻醉猫的五个时间点收集每次手术刺激后HR（HR时间）和PTAi（PTAi时间）达到其最低峰值所需的时间。每个收集到的手术刺激分为3组进行统计分析：无伤害感受检测、无血流动力学反应且PTAi>50（）；无血流动力学反应且PTAi<50（<50）；有血流动力学反应且PTAi<50（<50）。
与HR相比，PTAi反应在检测伤害感受方面显示出有效性。SS在组中占36.1%，在<50组中占50%，而在<50组中仅占13.9%。在<50组中，PTAi时间和HR时间在检测SS方面速度相似（=0.821）；然而，与<50组相比，<50组的PTA时间明显更慢（=0.001）。
PTA监测可能是补充HR监测以检测伤害感受的有用工具。在接受OV的猫中，PTA监测在检测伤害感受方面显示出比HR更高的诊断价值，并且在HR增加超过20%时检测SS的速度与HR相似。未来需要开展研究，以在临床环境中了解当HR增加与临床无关时，使用PTA监测仪检测到的交感神经激活/伤害感受的意义。
