Autonomic nervous system (ANS) activity can modify cardiovascular parameters in response to nociceptive stimuli or drugs in anesthetized animals. The aim of this study was to determine if a surgical nociceptive stimulus and morphine, ketamine, and dobutamine administration would modify ANS activity observed as a change in the mean parasympathetic tone activity (PTAm) in anesthetized horses. In 20 anesthetized horses, heart rate (HR), mean arterial pressure (MAP), and PTAm were monitored before and 1, 3, and 5 min after surgical incision, and before and 10 min after the administration of morphine (0.2 mg/kg IV). If nystagmus or spontaneous ventilation was observed, ketamine (0.5 mg/kg IV) was given, and the three variables were registered before and 3 and 5 min afterward. If MAP reached ≤ 62 mmHg, a dobutamine infusion was administered, and the three variables were recorded before and 5 min after starting/increasing the infusion (0.25 μg/kg/min IV every 5 min). The three variables were registered before and 1, 3, and 5 min after a PTAm decrease of ≥ 20%, HR increase of ≥ 10%, or MAP increase of ≥ 20%. The PTAm decreased 3 min after the administration of ketamine and 1 min after a PTA event. The surgical incision, dobutamine, and morphine did not modify PTAm. The absence of changes in ANS activity after the nociceptive stimulus and lack of correlation between PTAm and HR or MAP suggest that PTAm is a poor indicator of sympathetic activation under the study conditions. Ketamine seems to affect ANS activity by decreasing PTAm.
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BackgroundThe bispectral index (BIS) has been evaluated as an indicator of central nervous system (CNS) depression in horses during general anaesthesia. The spectral entropy is another electroencephalographic device and it has not been evaluated yet in horses.ObjectivesTo determine if spectral entropy can assess anaesthetic depth during the different phases of anaesthesia, define the value of state and response entropy during surgical plane of anaesthesia and compare them with BIS.Study designClinical, prospective, non‐blinded observational study.MethodsThirty‐five horses ASA I or II undergoing scheduled surgical procedure were used. BIS and electromyography (EMG) with a BIS monitor and state and response entropy with a spectral entropy monitor were recorded at baseline after receiving 5 µg/kg bwt i.v. of medetomidine (sedation period), during the anaesthetic maintenance with isoflurane and medetomidine (intraoperative period) and once the trachea was extubated (recovery period). A general linear model for repeated measurements was employed. Correlation and agreement between methods were also assessed. Data are presented as mean ± SD.ResultsState entropy, response entropy and EMG showed significant differences according to the anaesthetic period (P < .001). There was no significant difference in BIS between baseline and sedation period, but there were differences between the remainder of the periods (P < .001). BIS (53.4 ± 11.2) was significantly higher (P < .001) than response entropy (35.1 ± 7.1) and state entropy (27.4 ± 4.8) during surgical plane of anaesthesia. The ICC between BIS and response entropy was 0.56 and between BIS and state entropy was 0.43, without agreement between them.Main limitationsThe need to shave the skin in contact with the sensors and the difficulty in taking measurements during recovery period.ConclusionsSpectral entropy can be used to detect the different periods of an anaesthetic protocol, with the lowest values during the intraoperative period. A low correlation and no concordance were observed between both methods.
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