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Veterinary anaesthesia and analgesia2019; 47(2); 152-159; doi: 10.1016/j.vaa.2019.09.006

Intraoperative nociception-antinociception monitors: A review from the veterinary perspective.

Abstract: To review monitors currently available for the assessment of nociception-antinociception in veterinary medicine. Methods: PubMed, Web of Science and Google Scholar. The results were initially filtered manually based on the title and the abstract. Conclusions: The provision of adequate antinociception is difficult to achieve in veterinary anaesthesia. Currently, heart rate and arterial blood pressure are used to monitor the response to a noxious stimulus during anaesthesia, with minimum alveolar concentration-sparing effect and stress-related hormones used for this purpose in research studies. However, since none of these variables truly assess intraoperative nociception, several alternative monitoring devices have been developed for use in humans. These nociceptive-antinociceptive monitoring systems derive information from variables, such as electroencephalography, parasympathetic nervous system (PNS) response, sympathetic nervous system response and electromyography. Several of these monitoring systems have been investigated in veterinary medicine, although few have been used to assess intraoperative nociception in animals. There is controversy regarding their effectiveness and clinical use in animals. A nociceptive-antinociceptive monitoring system based on the PNS response has been developed for use in cats, dogs and horses. It uses the parasympathetic tone activity index, which is believed to detect inadequate intraoperative nociception-antinociception balance in veterinary anaesthesia. Nonetheless, there are limited published studies to date, and cardiovascular variables remain the gold standard. Consequently, further studies in this area are warranted.
Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
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Publication Date: 2019-11-16 PubMed ID: 32007442DOI: 10.1016/j.vaa.2019.09.006Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article examines the devices used to monitor the balance of pain and pain relief (nociception-antinociception) in veterinary anesthesia procedures. The study recognizes that providing adequate pain relief for animals during surgery can be challenging, and that current methods for monitoring pain do not directly estimate nociception, which lead to the development of alternative devices.

Study Methodology

  • The researchers conducted a review, obtaining data from large scientific databases like PubMed, Web of Science, and Google Scholar.
  • These findings were filtered manually based on the research paper’s title and abstract to identify the most relevant ones for their review.

Current State of Veterinary Anaesthesia Monitoring

  • The article highlights that ensuring appropriate antinociception or pain relief in veterinary anesthesia is a challenging task.
  • At present, heart rate and arterial blood pressure are used to monitor an animal’s response to harmful or potentially painful stimuli during anesthesia.
  • The research studies often utilize the minimum alveolar concentration-sparing effect and stress-related hormones for this purpose.
  • Nevertheless, the article notes that none of these variables can truly assess intraoperative nociception—the transmission and perception of pain in the body.

Alternative Monitoring Devices

  • Due to the limitations of current methods, several alternative monitoring devices that were initially developed for humans are now being explored in a veterinary context.
  • These novel nociceptive-antinociceptive monitoring systems extract information from variables like electroencephalography (brain wave activity), responses of the parasympathetic (PNS) and sympathetic nervous systems, and electromyography (electrical activity of muscles).
  • However, the use of these devices in assessing intraoperative nociception in animals has been limited and there is controversy around their effectiveness and clinical application in veterinary medicine.

Parasympathetic Tone Activity Index

  • A nociceptive-antinociceptive monitoring system that is based on the PNS response has been developed for use in cats, dogs, and horses.
  • This system utilizes the parasympathetic tone activity index, which is believed to provide a more accurate depiction of inadequate intraoperative nociception-antinociception balance in veterinary anesthesia.
  • However, there are currently very few published studies evaluating this nascent technology.

Conclusion

  • Despite these developments, the article concludes that cardiovascular variables remain the gold standard in monitoring pain and pain relief during veterinary surgeries.
  • As such, the authors recommend further research into nociception-antinociception monitoring in a veterinary context, offering better assessment and management of pain during veterinary surgical procedures.

Cite This Article

APA
Ruíz-López P, Domínguez JM, Granados MDM. (2019). Intraoperative nociception-antinociception monitors: A review from the veterinary perspective. Vet Anaesth Analg, 47(2), 152-159. https://doi.org/10.1016/j.vaa.2019.09.006

Publication

Veterinary anaesthesia and analgesia
ISSN: 1467-2995
NlmUniqueID: 100956422
Country: United States
Language: English
Volume: 47
Issue: 2
Pages: 152-159
PII: S1467-2987(19)30315-0

Researcher Affiliations

Ruíz-López, Patricia
  • Anaesthesiology Unit, Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, Córdoba, Spain. Electronic address: ruizlopezpatricia@gmail.com.
Domínguez, Juan Manuel
  • Anaesthesiology Unit, Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, Córdoba, Spain.
Granados, María Del Mar
  • Anaesthesiology Unit, Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, Córdoba, Spain.

MeSH Terms

  • Analgesics / administration & dosage
  • Analgesics / pharmacology
  • Anesthesia / veterinary
  • Animals
  • Intraoperative Complications / veterinary
  • Monitoring, Physiologic
  • Pain Measurement / methods
  • Pain Measurement / veterinary

Citations

This article has been cited 20 times.
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