The measurement of neurovegetative activity during anesthesia and surgery in swine: an evaluation of different techniques.

In this study we evaluated, in 10 sevoflurane-anesthetized pigs undergoing abdominal surgery, different techniques for measuring autonomic nervous system (ANS) activity: ANSiscope index, spectral analysis of heart-rate variability, hemodynamic variables, and plasma catecholamines and cortisol levels. Animals underwent a 120-min anesthesia during which unilateral ovariectomy was performed. Cardiovascular and respiratory responses were monitored. ANSiscope indices (ANSindex sympathetic, ANSindex parasympathetic and balANSindex) were used to monitor ANS activity. Spectral analysis was performed using an autoregressive model with a parametric method. The low frequency (LF) and high frequency (HF) components were used to interpret the power spectral density of short-term electrocardiograms (ECGs). The relationship LF/(LF+HF) reflects sympathetic activity, HF/(LF+HF) indicates parasympathetic activity, and the LF/HF ratio gives the predominance of the system. Plasma concentrations of adrenaline, noradrenaline, and cortisol were determined at different times. Correlation (P < 0.01) was found between the balANSindex and adrenaline levels and between LF/HF ratio and plasma adrenaline concentrations. Moreover, a significant (P < 0.01) correlation was found between the balANSindex and LF/HF ratio. However, no correlation was seen between the registered ANSiscope indices and hemodynamic variables. The correlation seen in this study suggests that the balANSindex could be a useful tool to monitor ANS activity during anesthesia and surgery.

Bispectral index, spectral edge frequency 95% and median frequency recorded at varying desflurane concentrations in pigs.

The objective of this study is to evaluate the usefulness of bispectral index (BIS), spectral edge frequency 95% (SEF) and median frequency (MED) in relation to a simple descriptive scale (SDS) as indicators of anaesthetic depth at different desflurane concentrations in swine. Sixteen pigs were randomly allocated to four groups. Electroencephalograms (EEG) were recorded during desflurane anaesthesia, and BIS, SEF and MED were calculated from the EEG. The agent was administered in pure oxygen at 1, 1.25, 1.5 and 1.7 MAC in randomized order. Anaesthetic depth was evaluated on a SDS. BIS decreased significantly (P<0.001) at the different anaesthetic dosages used. SEF decreased significantly (P<0.001) from basal to 1 MAC of desflurane. MED decreased significantly (P<0.001) from basal to 1 MAC and from 1 to 1.75 MAC. Good correlation was seen between SDS scores and BIS values and between SDS scores and MED values. BIS appeared to be useful to predict changes in anaesthetic depth at clinically used dosages of inhalant anaesthesia.

Relationships between a proprietary index, bispectral index, and hemodynamic variables as a means for evaluating depth of anesthesia in dogs anesthetized with sevoflurane.

OBJECTIVE: To evaluate relationships among various techniques for monitoring anesthetic depth in sevoflurane-anesthetized dogs undergoing orthopedic surgery. ANIMALS: 10 dogs. PROCEDURE: Dogs were medicated with acepromazine (0.05 mg/kg, IM), buprenorphine (0.01 mg/kg, IM), and atropine (0.04 mg/kg, IM). Anesthesia was induced and maintained with sevoflurane. Cardiovascular and respiratory responses were monitored. Anesthetic depth was monitored by use of the bispectral index (BIS), and a proprietary index was used to monitor activity of the autonomic nervous system. RESULTS: A significant decrease in BIS was seen after induction but concurrent changes were not observed for the other techniques. The proprietary index increased significantly after intubation, but no changes were seen for the other techniques. No significant changes were detected during incision or when higher nociceptive stimuli were applied. We did not identify a correlation between BIS and the proprietary index, the proprietary index and hemodynamic variables, or the BIS and hemodynamic variables during induction and maintenance. A significant increase in the proprietary index and BIS was detected at the time of resumption of reflexes. During anesthetic recovery, a correlation was found between the proprietary index and BIS but not between hemodynamic variables and the other techniques. CONCLUSIONS AND CLINICAL RELEVANCE: A significant increase in the proprietary index, but not the BIS or hemodynamic variables, was detected during intubation. Anesthetic induction with sevoflurane did not prevent the sympathetic stimulus attributable to tracheal intubation. Monitoring of hemodynamic variables does not provide sufficient information to allow clinicians to evaluate stress during anesthetic recovery.

Assessment of the relationship of bispectral index values, hemodynamic changes, and recovery times associated with sevoflurane or propofol anesthesia in pigs.

OBJECTIVE: To evaluate bispectral index (BIS) values in pigs during anesthesia maintained with sevoflurane-fentanyl or propofol-fentanyl as a predictor of changes in hemodynamic parameters and duration of recovery from anesthesia. ANIMALS: 12 pigs. PROCEDURE: Pigs were randomly allocated to undergo 1 of 2 anesthetic regimens. Anesthesia was induced with propofol (2 mg/kg, i.v.); 6 pigs were administered sevoflurane via inhalation (1 minimum alveolar concentration [MAC] at a fresh gas flow rate of 3 L/min; group I), and 6 were administered propofol (11 mg/kg/h, i.v.; group II). All pigs received fentanyl (2.5 mg/kg, i.v., q 30 min). After abdominal surgery, pigs were allowed to recover from anesthesia. Cardiovascular variables and BIS values were recorded at intervals throughout the procedure; duration of recovery from anesthesia was noted. RESULTS: No correlation was established between arterial blood pressure and BIS and between heart rate and BIS. Mean BIS at discontinuation of administration of the anesthetic agent was greater in group-II pigs (65.2 +/- 10.6 minutes) than in group-I pigs (55.8 +/- 2.9 minutes). However, recovery from anesthesia was significantly longer in group II (59.80 +/- 2.52 minutes) than in group I (9.80 +/- 2.35 minutes). CONCLUSIONS AND CLINICAL RELEVANCE: In swine anesthetized with sevoflurane or propofol and undergoing abdominal surgery, the BIS value derived from an electroencephalogram at the end of anesthesia was not useful for predicting the speed of recovery from anesthesia. Moreover, BIS was not useful as a predictor of clinically important changes in arterial blood pressure and heart rate in those anesthetized pigs.