The objective of this article was to review the present methods used for validating the depth of hypnosis. We introduce three concepts, the real depth of hypnosis (DHreal), the observed depth of hypnosis (DHobs), and the electronic indices of depth of hypnosis (DHel-ind). The DHreal is the real state of hypnosis that the patient has in a given moment during the general anaesthesia. The DHobs is the subjective assessment of the anaesthesiologist based on clinical signs. The DHel-ind is any estimation of the depth of hypnosis given by an electronic device. The three entities DHreal, DHobs and DHel-ind should in the ideal situation be identical. However, this is rarely the case. The correlation between the DHobs and the DHel-ind can be affected by a number of factors such as the stimuli used for the assessment of the level of consciousness or the administration of analgesic agents or neuro muscular blocking agents. Opioids, for example, can block the response to tactile and noxious stimuli, and even the response to verbal command could vanish, hence deeming the patient in a lower depth of hypnosis than the real patient state. The DHel-ind can be disturbed by the presence of facial muscular activity. In conclusion, although several monitors and clinical scoring scales are available to assess the depth of hypnosis during general anaesthesia, care should be taken when interpreting their results.
The most widely used stunning method in sheep is electrical. However, in lambs, this method leads to rupture of the blood vessels, provoking ecchymoses. In pigs (Sus scrofa), the use of CO2-stunning systems has increased in popularity due to positive effects on meat quality and animal welfare (movement of animals in groups). The aim here was to assess the effectiveness of a progressive exposure to 90% carbon dioxide (CO2) in inducing unconsciousness in lambs (Ovis aries) through changes in the middle latency auditory-evoked potentials (MLAEP) of the central nervous system (CNS), blood parameters (pH, carbon dioxide partial pressure (pCO2), oxygen partial pressure (pO2), oxygen saturation (SatO2) and bicarbonate (HCO3J, behaviour (head-shaking, sneezing, gasping and gagging) and physiological reflexes (corneal reflex, breathing and sensitivity to pain). Fourteen male lambs of the Ripollesa breed, weighing between 19 and 25 kg were progressively exposed to an atmosphere of 90% CO2 over 66 s. All blood parameters changed between 23 and 43 s after the onset of the immersion. The MLAEP did not decrease significantly until after 48 s exposure to CO2, suggesting an absence of auditory-evoked brain activity. Before that, lambs exhibited head-shaking and sneezing starting at 10.6 (± 0.77) s, and gasping starting at 20.6 (± 1.36) s. After exposure, all animals showed absence of breathing and sensibility to pain, and 36% of them absence of corneal reflex. The pH and pCO2 recovered basal values at 90 and 120 s, respectively, after the end of the exposure. The burst suppression index (BS%) and the A-Line ARX index (AAI) recovered basal levels at 116 and 159 s, respectively. Exposure to CO2 at high concentration induces effective stunning in sheep for a period of 124 s. However, during exposure, the animals exhibited signs of aversion and breathlessness.
The results indicate that the peroperative depth of anaesthesia may have effects on the postoperative analgesic requirements.
The aim of this study was to assess unconsciousness in pigs during exposure to CO2 through changes in the middle latency auditory evoke potentials (MLAEP) of the central nervous system (CNS), blood parameters (pH, carbon dioxide partial pressure [pCO2], oxygen partial pressure [pO2], oxygen saturation [SatO2] and bicarbonate [HCO−3]), behaviour and the corneal reflex. The MLEAP did not decrease significantly until after 60 s exposure to CO2. The blood parameters (decreased pH, pO2 and SatO2 and increased pCO2 and HCO3) changed 53 s after the onset of immersion. The burst suppression index (BS%) and the A-line ARX index (AAI) from the MLEAP recovered basal levels at 136 and 249 s, respectively. The first blood parameter to return to basal levels was HCO−3 at 76 s of exposure, followed by SatO2 at 180 s, pH and pO2 at 210 s and pCO2 at 240 s. During exposure to the gas, pigs exhibited lateral head movements and sneezing (10.3 s), gasping (23.5 s) and vocalisation (26.1 s). Furthermore, all pigs demonstrated muscular excitation after between 19 and 39 s exposure, when the AAI and BS% values were not significantly different from basal values. It was suggested, therefore, that these excitatory movements represent conscious movement, indicative of aversion to the gas. According to our results, loss of consciousness began, on average, after 60 s inhalation of 90% CO2. During exposure to the gas, decreased brain activity was seen, immediately following the changes in blood parameters. Following exposure, the restoration of blood parameters to basal levels allows a return to normal brain activity.
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