Subarachnoid pressures and cardiorespiratory parameters during cisternal myelography in isoflurane anaesthetized dogs

Arany‐Tóth, Attila; Csébi, Péter; Reiczigel, Jenő; Sére, Viktoria; Németh, Tibor

doi:10.1111/vaa.12019

Cited by 7 publications

(21 citation statements)

References 28 publications

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“…There was an association between highest cisternal pressure and both body weight and body length ( r = 0.75 and 0.71). As published elsewhere, dogs with highest subarachnoid pressure and lowest cerebral perfusion pressure values often exhibited the typical cardiorespiratory signs (bradycardia, apnea, hypertension) of increased intracranial pressure.…”

Section: Discussionsupporting

confidence: 57%

“…Subarachnoid pressure was very high in some dogs during myelography and the change of certain cardiorespiratory parameters was consistent with transient cerebral hypoxia . However, lack of complete follow up after procedure did not allow us to study the correlation between increased intracranial pressure and postmyelographic neurologic complications.…”

Section: Discussionmentioning

confidence: 97%

“…Hence, we made our PVI calculations for a mixed patient group that generally represents dogs referred for myelography. We also suggest using a dose calculated for an average “spinal population” and to perform individual monitoring for signs of intracranial hypertension to detect “outliers.”…”

Section: Discussionmentioning

confidence: 99%

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Pressure–volume Index‐based Volume Calculation of Contrast Medium for Atlanto‐occipital Myelography in Dogs

Arany‐Tóth¹,

Csébi²,

Reiczigel

et al. 2012

Vet Radiology Ultrasound

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Subarachnoid pressure recordings were made during atlanto-occipital myelography in 45 dogs with clinical signs of spinal disease. Iohexol was injected at a dosage of 0.3 ml/kg body weight and simultaneous pressure values were recorded in the cerebellomedullary cistern. The mean subarachnoid pressure was 9 ± 3 mmHg before and 70 ± 32 mmHg at the end of administration. From the pressure change induced by the volume load, the pressure-volume index (PVI) of the subarachnoid space was calculated and found to be in close correlation with body weight and the crown-rump length (r = 0.94 and 0.87). Using the estimated PVI values, the appropriate volume of contrast medium can be calculated for an animal according to body weight. Dogs of a large body size require relatively less contrast medium than small-sized dogs (range 0.17-0.35 ml/kg). This calculated volume is unlikely to increase the subarachnoid pressure above 40 mmHg as a specific pressure limit. Using these data, simplified recommendations for the choice of contrast medium volumes have been generated.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 97%

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Pressure–volume Index‐based Volume Calculation of Contrast Medium for Atlanto‐occipital Myelography in Dogs

Arany‐Tóth¹,

Csébi²,

Reiczigel

et al. 2012

Vet Radiology Ultrasound

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“…These include, rat contention for cisterna magna puncturing (to carry out the pilot of this work, we tried the technique described by Jeffers and Griffith (1942), apud Waynforth and Flecknell (1992), and by Melartin et al (1970), however, when performing the radiography control, a significant extravasation of CM through the subarachnoid space was found), the concentration of the CM used (higher iodine concentrations reflected an increase in osmolality and consequent increased risk of side effects) (FATONE et al, 1997), the anesthetic protocol used (this can affect the respiratory depression; such as isoflurane, which has a direct influence on medullar ventilation center and indirect effect on the intercostal muscles), the rate of administration (hasty administration can cause the CM to flow into the rostral subarachnoid space accumulating in the fourth ventricle and cerebellar hemisphere, increasing the intracranial pressure, indicated by clinical signs including bradycardia and apnea that are related to a reduction of cerebral blood flow) (LEITE et al, 2002;ARANY-TÓTH et al, 2013) and preheating the CM (with a rise of temperature, there is a viscosity reduction) (UCHIYAMA et al, 2006). Tables 1 and 2 shows the signs of depression and excitement, respectively, observed from 5 min to the application of the substance (iohexol, iobitridol or ACF) in five different doses.…”

Section: Resultsmentioning

confidence: 99%

“…The findings of this study seem to reflect the neurotoxic effect of iobitridol and iohexol, as seizures are commonly reported as neurotoxic effects of CMs, especially when the applications are made through the cisterna magna (LEITE et al, 2002). Other potential causative factors include, an increased duration of anesthesia (this was greater in the animals where higher doses of CM were used, in order to maintain the administration rate), an increased intracranial pressure (which can contribute to the reduction of cerebral circulation and lead to the development of neurological complications after the application of the CM) (ARANY-TÓTH et al, 2013), and the anesthetic protocol used (LEITE et al, 2002).…”

Section: Mgmentioning

confidence: 99%

Comparative neurotoxicity of iobitridol with iohexol by intracisternal administration in Wistar rats

Mello

Stédile

Gouvêa

et al. 2017

SCA

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Iobitridol is a tri-iodinated contrast agent, and neurotoxicologic studies of the intracisternal administration are scarce and inconclusive. The purpose of this study was to compare the neurotoxicity of iobitridol with iohexol, by intracisternal administration in Wistar rats, for a pre-clinical evaluation of its use as a myelographic agent. The animals, a total of 75, were divided into three experimental groups, iobitridol, iohexol and cerebral artificial fluid (control group), with 25 animals per group. Then, these were divided into five subgroups of five animals each, and given doses of 200, 400, 600, 800 and 1000 mg kg -1 , while the control group received the equivalent volumes of contrast media tested. The animals were evaluated after 5, 15, 30, 60, 120, 180 and 240 min of intracisternal administration of these substances, for signs of depression and excitement, tactile palmar grasp, flexor, extensor, palpebral, papillary and pinna reflexes, surface righting and placing reactions, and with an auditory startle test. The evaluations were assessed daily for seven days with these parameters and their body weight, food, and water intake were also measured. There were no statistically significant differences between groups tested with respect to any of the evaluated parameters. In other words, in this animal model, the iobitridol demonstrated a low neurotoxicologic potential, comparable to that observed with iohexol. Further study with dogs and cats, as an alternative, is suggested. Key words: Contrast media. Cistern. Iodinated contrast. Myelography. Toxicity. ResumoO iobitridol é um meio de contraste tri-iodado, e estudos referentes à neurotoxicidade, com administração subaracnóide são escassos e inconclusivos. O objetivo deste trabalho foi comparar a neurotoxicidade do iobitridol com a do iohexol, por via intracisternal, em ratos Wistar, como avaliação pré-clínica da utilização deste como agente mielográfico. Foram utilizados 75 animais divididos em três grupos experimentais com 25 animais: iobitridol, iohexol e líquido cerebroespinhal artificial (grupo controle). Estes foram subdivididos em cinco subgrupos com cinco animais cada, com doses distintas de 200, 400, 600, 800 e 1000 mg kg -1 , sendo utilizado no grupo controle o volume equivalente aos meios de contraste testados. Os animais foram avaliados após 5, 15, 30, 60, 120, 180 palmar, flexor, extensor, palpebral, pupilar e da pina, reação de endireitamento e posicionamento e resposta auditiva. Nos sete dias subsequentes, os animais foram avaliados diariamente quanto a estes parâmetros, e ainda a massa corporal, a ingestão de ração e de água, foram mensuradas. Não foram observadas diferenças estatisticamente significativas entre os grupos testados com meios de contraste, em nenhum dos parâmetros avaliados. Dessa forma, nesse modelo animal, o iobitridol demonstrou baixa neurotoxicidade, comparável a observada com o iohexol. Sugerem-se mais estudos com cães e gatos para utilização do iobitridol como alternativa. . Palavras-chave: Cisterna. Contraste ...

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Cardiorespiratory findings during iohexol contrast myelography in horses under total intravenous anaesthesia

Loomes¹

2021

Equine Veterinary Education

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Summary Background Iohexol myelography is used to investigate cervical vertebral pathology in horses but the cardiorespiratory changes during the procedure under total intravenous anaesthesia (TIVA) have not yet been reported. Objectives To analyse heart rate (HR), arterial blood pressure (ABP) and respiratory rate (RR) changes in horses during iohexol contrast myelography under TIVA. Study design Retrospective review of anaesthetic records. Methods Anaesthetic records from 70 horses undergoing iohexol contrast myelography under TIVA were reviewed. Heart rate, arterial blood pressure and respiratory rate at six time points; baseline (10 min prior to needle insertion), needle insertion, withdrawal of cerebrospinal fluid (CSF), iohexol contrast injection, needle removal and post‐procedure (10 min after needle removal) were analysed. Data were analysed using paired and two‐sample t‐tests, Mann–Whitney U test, Wilcoxon signed rank test, ANOVA, Pearson’s correlation and logistic regression. Results Forty‐five records contained complete data. Mean HR and ABP were not significantly different from baseline at any time point during the procedure. Overall, median RR was significantly higher during contrast injection (p < 0.001), at needle removal (p < 0.001) and post‐procedure (p < 0.001) compared to baseline. Premedication with acepromazine, romifidine and butorphanol (ARB) was associated with a significantly lower RR at needle removal compared to premedication with romifidine (R), romifidine and butorphanol (RB) or acepromazine and romifidine (AR) (p < 0.05). Premedication with ARB or AR was associated with a lower incidence of tachypnoea (RR >20 breaths/min) at needle removal compared to R and RB (p = 0.005). Main limitations Retrospective design and small sample size. Conclusions There was little fluctuation in HR and ABP during iohexol myelography in healthy horses under TIVA. Tachypnoea occurred during or after subarachnoid iohexol administration in 55% of horses. Acepromazine premedication reduced the incidence of tachypnoea, however, the cause of this respiratory response requires further investigation.

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Subarachnoid pressures and cardiorespiratory parameters during cisternal myelography in isoflurane anaesthetized dogs

Cited by 7 publications

References 28 publications

Pressure–volume Index‐based Volume Calculation of Contrast Medium for Atlanto‐occipital Myelography in Dogs

Pressure–volume Index‐based Volume Calculation of Contrast Medium for Atlanto‐occipital Myelography in Dogs

Comparative neurotoxicity of iobitridol with iohexol by intracisternal administration in Wistar rats

Cardiorespiratory findings during iohexol contrast myelography in horses under total intravenous anaesthesia

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