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Does the A-line ARX-lndex provide a reasonable assessment of anaesthetic depth in dogs undergoing routine surgery?
J S Afr Vet Assoc. 2004 Sep; 75(3):110-5.JS

Abstract

The monitoring of anaesthetic depth is usually based on the subjective assessment of the patient. An objective assessment of anaesthesia has only recently become possible. The auditory-evoked response has predictable changes in response to increasing doses of anaesthetic agents. Recent advances have brought about a regression model with exogenous input of the auditory-evoked response, the A-line ARX-Index (AAI Index). The AAI Index is a dimensionless number between 0 and 100. This technology has been incorporated into the AEP (auditory-evoked potential) monitor that is utilised to assess anaesthetic depth in humans. This study was undertaken to determine if the AEP monitor was useful in dogs. Ten dogs were enrolled in the study. After a full clinical and otoscopic examination, dogs were premedicated with acetylpromazine and morphine. Anaesthesia was induced with thiopentone and maintained with halothane. End-tidal carbon dioxide, temperature, pulse oximetry, blood pressure and the electrocardiogram were monitored and recorded every 5 minutes. Anaesthetic depth was assessed as either being adequate or inadequate by the anaesthetist during surgery. An AEP monitor was attached to the patient and automatically collected AAI Index data. The anaesthetist was blinded to the AEP monitor. Following the completion of the surgical procedure, the patient was allowed to wake up with the AEP monitor attached. The AAI Index was analysed to compare adequate with inadequate anaesthesia during the period of surgery and awake with sleep data during recovery. All AAI Index values associated with inadequate anaesthesia were greater than 31 while adequate values were less than 35. The difference between the groups was statistically significant and the power was 0.97. Statistically, the awake and sleep values were significantly different with a power of 0.99. From this study it can be concluded that the AAI Index shows good prospect for the evaluation of anaesthetic depth in dogs undergoing surgery. A larger study is needed to confirm these results.

Authors+Show Affiliations

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110, South Africa. kenneth.joubert@up.ac.za

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15628801

Citation

Joubert, K E.. "Does the A-line ARX-lndex Provide a Reasonable Assessment of Anaesthetic Depth in Dogs Undergoing Routine Surgery?" Journal of the South African Veterinary Association, vol. 75, no. 3, 2004, pp. 110-5.
Joubert KE. Does the A-line ARX-lndex provide a reasonable assessment of anaesthetic depth in dogs undergoing routine surgery? J S Afr Vet Assoc. 2004;75(3):110-5.
Joubert, K. E. (2004). Does the A-line ARX-lndex provide a reasonable assessment of anaesthetic depth in dogs undergoing routine surgery? Journal of the South African Veterinary Association, 75(3), 110-5.
Joubert KE. Does the A-line ARX-lndex Provide a Reasonable Assessment of Anaesthetic Depth in Dogs Undergoing Routine Surgery. J S Afr Vet Assoc. 2004;75(3):110-5. PubMed PMID: 15628801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does the A-line ARX-lndex provide a reasonable assessment of anaesthetic depth in dogs undergoing routine surgery? A1 - Joubert,K E, PY - 2005/1/5/pubmed PY - 2005/2/3/medline PY - 2005/1/5/entrez SP - 110 EP - 5 JF - Journal of the South African Veterinary Association JO - J S Afr Vet Assoc VL - 75 IS - 3 N2 - The monitoring of anaesthetic depth is usually based on the subjective assessment of the patient. An objective assessment of anaesthesia has only recently become possible. The auditory-evoked response has predictable changes in response to increasing doses of anaesthetic agents. Recent advances have brought about a regression model with exogenous input of the auditory-evoked response, the A-line ARX-Index (AAI Index). The AAI Index is a dimensionless number between 0 and 100. This technology has been incorporated into the AEP (auditory-evoked potential) monitor that is utilised to assess anaesthetic depth in humans. This study was undertaken to determine if the AEP monitor was useful in dogs. Ten dogs were enrolled in the study. After a full clinical and otoscopic examination, dogs were premedicated with acetylpromazine and morphine. Anaesthesia was induced with thiopentone and maintained with halothane. End-tidal carbon dioxide, temperature, pulse oximetry, blood pressure and the electrocardiogram were monitored and recorded every 5 minutes. Anaesthetic depth was assessed as either being adequate or inadequate by the anaesthetist during surgery. An AEP monitor was attached to the patient and automatically collected AAI Index data. The anaesthetist was blinded to the AEP monitor. Following the completion of the surgical procedure, the patient was allowed to wake up with the AEP monitor attached. The AAI Index was analysed to compare adequate with inadequate anaesthesia during the period of surgery and awake with sleep data during recovery. All AAI Index values associated with inadequate anaesthesia were greater than 31 while adequate values were less than 35. The difference between the groups was statistically significant and the power was 0.97. Statistically, the awake and sleep values were significantly different with a power of 0.99. From this study it can be concluded that the AAI Index shows good prospect for the evaluation of anaesthetic depth in dogs undergoing surgery. A larger study is needed to confirm these results. SN - 1019-9128 UR - https://www.unboundmedicine.com/medline/citation/15628801/Does_the_A_line_ARX_lndex_provide_a_reasonable_assessment_of_anaesthetic_depth_in_dogs_undergoing_routine_surgery DB - PRIME DP - Unbound Medicine ER -