{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T22:50:38Z","timestamp":1778107838210,"version":"3.51.4"},"reference-count":32,"publisher":"American Veterinary Medical Association (AVMA)","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2023,5,31]]},"abstract":"Abstract<\/jats:title>\n\nOBJECTIVE<\/jats:title>\nTo evaluate the effects of rocuronium and sugammadex on the patient state index (PSI) in dogs anesthetized with propofol.<\/jats:p>\n<\/jats:sec>\n\nANIMALS<\/jats:title>\n6 intact healthy male Beagles.<\/jats:p>\n<\/jats:sec>\n\nPROCEDURES<\/jats:title>\nAnesthesia was induced with and maintained on a propofol infusion. The estimated plasma propofol concentration (ePC) was recorded. Baseline PSI and train-of-four ratio (TOFR) readings were collected for 2 minutes in stable general anesthesia. Neuromuscular blockade (NMB) was induced with 0.6 mg\/kg, IV, rocuronium, and full NMB was confirmed with a TOFR of 0. After 5 minutes, the neuromuscular function was restored with 4 mg\/kg sugammadex, IV (reversal), and monitored for 5 minutes. Throughout the data collection, ePC, PSI, and TOFR were recorded every 15 seconds and compared with mixed-effect ANOVA.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nBaseline ePC, PSI, and TOFR were 3.63 \u00b1 0.38, 41 \u00b1 6, and 0.97 \u00b1 0.08 \u00b5g\/mL, respectively. There was no difference between the baseline of ePC and PSI from NMB or reversal. Compared to the baseline, the TOFR decreased to 0 with NMB (P<\/jats:italic> < .001) and returned to 0.96 \u00b1 0.08 (P<\/jats:italic> = .721) on reversal. After 5 minutes, sugammadex fully reversed 5 out of 6 dogs to TOFR > 0.90 and partially reversed 1 animal to TOFR = 0.80.<\/jats:p>\n<\/jats:sec>\n\nCLINICAL RELEVANCE<\/jats:title>\nThere was no evidence that NMB with rocuronium and sugammadex-induced reversal interfered with PSI readings under steady-state total intravenous anesthesia with propofol. Further evaluation of PSI is warranted to assess its utility in a clinical population to detect changes in levels of consciousness during NMB.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.23.03.0050","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T12:01:46Z","timestamp":1685448106000},"page":"1-7","source":"Crossref","is-referenced-by-count":4,"title":["Rocuronium-neuromuscular blockade does not influence the patient state index in anesthetized dogs"],"prefix":"10.2460","author":[{"given":"Charlotte C.","family":"Burns","sequence":"first","affiliation":[{"name":"Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick J.","family":"Torpy","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah A.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather N.","family":"Trenholme","sequence":"additional","affiliation":[{"name":"Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel A.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Martin-Flores","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"6","key":"B1","series-title":"Anesth Analg","first-page":"1669","article-title":"A comparison of patient state index and bispectral index values during the perioperative period","volume":"95","author":"Chen X","year":"2002","unstructured":"Chen X, Tang J, White PF, et al. A comparison of patient state index and bispectral index values during the perioperative period. Anesth Analg. 2002;95(6):1669\u20131674. doi:10.1097\/00000539-200212000-00036"},{"issue":"3","key":"B2","series-title":"J Zoo Wildl Med","first-page":"729","article-title":"Potential for electroencephalographic monitoring of anesthetic depth in captive chimpanzees (Pan troglodytes) using a novel brain function monitor","volume":"51","author":"Mulreany LM","year":"2020","unstructured":"Mulreany LM, Cushing AC, Ashley AL, Smith CK. Potential for electroencephalographic monitoring of anesthetic depth in captive chimpanzees (Pan troglodytes) using a novel brain function monitor. J Zoo Wildl Med. 2020;51(3):729\u2013732. doi:10.1638\/2019-0193"},{"issue":"1","key":"B3","series-title":"Anesthesiology","first-page":"82","article-title":"Patient state index: titration of delivery and recovery from propofol, alfentanil, and nitrous oxide anesthesia","volume":"97","author":"Drover DR","year":"2002","unstructured":"Drover DR, Lemmens HJ, Pierce ET, et al. Patient state index: titration of delivery and recovery from propofol, alfentanil, and nitrous oxide anesthesia. Anesthesiology. 2002;97(1):82\u201389. doi:10.1097\/00000542-200207000-00012"},{"issue":"3","key":"B4","series-title":"J Anaesthesiol Clin Pharmacol","first-page":"348","article-title":"Effects of bispectral index monitoring on isoflurane consumption and recovery profiles for anesthesia in an elderly Asian population","volume":"28","author":"Shafiq F","year":"2012","unstructured":"Shafiq F, Naqvi H, Ahmed A. Effects of bispectral index monitoring on isoflurane consumption and recovery profiles for anesthesia in an elderly Asian population. J Anaesthesiol Clin Pharmacol. 2012;28(3):348\u2013352. doi:10.4103\/0970-9185.98335"},{"issue":"3","key":"B5","series-title":"Br J Anaesth","first-page":"393","article-title":"The Patient State Index as an indicator of the level of hypnosis under general anaesthesia","volume":"92","author":"Prichep LS","year":"2004","unstructured":"Prichep LS, Gugino LD, John ER, et al. The Patient State Index as an indicator of the level of hypnosis under general anaesthesia. Br J Anaesth. 2004;92(3):393\u2013399. doi:10.1093\/bja\/aeh082"},{"key":"B6","series-title":"Res Vet Sci","first-page":"66","article-title":"Evaluation of the electroencephalogram in awake, sedated, and anesthetized dogs","volume":"159","author":"Sakai DM","year":"2023","unstructured":"Sakai DM, Trenholme HN, Torpy FJ, Craig HA, Reed RA. Evaluation of the electroencephalogram in awake, sedated, and anesthetized dogs. Res Vet Sci. 2023;159:66\u201371. doi:10.1016\/j.rvsc.2023.04.008"},{"key":"B7","series-title":"Br J Anaesth","first-page":"i95","article-title":"Response of bispectral index to neuromuscular block in awake volunteers","volume":"115","author":"Schuller PJ","year":"2015","unstructured":"Schuller PJ, Newell S, Strickland PA, Barry JJ. Response of bispectral index to neuromuscular block in awake volunteers. Br J Anaesth. 2015;115:i95\u2013i103. doi:10.1093\/bja\/aev072"},{"issue":"8","key":"B8","series-title":"Am J Vet Res","first-page":"1","article-title":"Development and evaluation of a novel topically applied sildenafil citrate hydrogel and its influence on wound healing in dogs","volume":"83","author":"Sumner SM","year":"2022","unstructured":"Sumner SM, Wallace ML, Mulder AT, et al. Development and evaluation of a novel topically applied sildenafil citrate hydrogel and its influence on wound healing in dogs. Am J Vet Res. 2022;83(8):1\u20139. doi:10.2460\/ajvr.21.12.0209"},{"issue":"5","key":"B9","series-title":"Vet Anaesth Analg","first-page":"568","article-title":"A pharmacokinetic model optimized by covariates for propofol target-controlled infusion in dogs","volume":"46","author":"Cattai A","year":"2019","unstructured":"Cattai A, Bizzotto R, Cagnardi P, Di Cesare F, Franci P. A pharmacokinetic model optimized by covariates for propofol target-controlled infusion in dogs. Vet Anaesth Analg. 2019;46(5):568\u2013578. doi:10.1016\/j.vaa.2019.04.009"},{"issue":"7","key":"B10","series-title":"Acta Anaesthesiol Scand","first-page":"789","article-title":"Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: The Stockholm revision","volume":"51","author":"Fuchs-Buder T","year":"2007","unstructured":"Fuchs-Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby-Mogensen J. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: The Stockholm revision. Acta Anaesthesiol Scand. 2007;51(7):789\u2013808. doi:10.1111\/j.1399-6576.2007.01352.x"},{"issue":"3","key":"B11","series-title":"Anaesthesia","first-page":"236","article-title":"The influence of cold on the recovery of three neuromuscular blocking agents in man","volume":"51","author":"England AJ","year":"1996","unstructured":"England AJ, Wu X, Richards KM, Redai I, Feldman SA. The influence of cold on the recovery of three neuromuscular blocking agents in man. Anaesthesia. 1996;51(3):236\u2013240. doi:10.1111\/j.1365-2044.1996.tb13640.x"},{"issue":"1","key":"B12","series-title":"Asian Biomed","first-page":"73","article-title":"Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients","volume":"7","author":"Teng L","year":"2013","unstructured":"Teng L, Chen L, Ma H, Zhou Y, Li S. Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients. Asian Biomed. 2013;7(1):73\u201379. doi:10.5372\/1905-7415.0701.152"},{"issue":"24","key":"B13","series-title":"Vet Rec","first-page":"766","article-title":"Target-controlled infusion of propofol in dogs\u2013evaluation of four targets for induction of anaesthesia","volume":"157","author":"Musk GC","year":"2005","unstructured":"Musk GC, Pang DSJ, Beths T, Flaherty DA. Target-controlled infusion of propofol in dogs\u2013evaluation of four targets for induction of anaesthesia. Vet Rec. 2005;157(24):766\u2013770. doi:10.1136\/vr.157.24.766"},{"issue":"1","key":"B14","series-title":"Vet Anaesth Analg","first-page":"21","article-title":"Comparison between continuous rate infusion and target-controlled infusion of propofol in dogs: a randomized clinical trial","volume":"50","author":"Cuniberti B","year":"2022","unstructured":"Cuniberti B, Huuskonen V, Hughes JL. Comparison between continuous rate infusion and target-controlled infusion of propofol in dogs: a randomized clinical trial. Vet Anaesth Analg. 2022;50(1):21\u201330. doi:10.1016\/j.vaa.2021.08.048"},{"issue":"4","key":"B15","series-title":"Vet Anaesth Analg","first-page":"727","article-title":"Effect of fentanyl on the induction dose and minimum infusion rate of propofol preventing movement in dogs","volume":"44","author":"Davis CA","year":"2017","unstructured":"Davis CA, Seddighi R, Cox SK, Sun X, Egger CM, Doherty TJ. Effect of fentanyl on the induction dose and minimum infusion rate of propofol preventing movement in dogs. Vet Anaesth Analg. 2017;44(4):727\u2013737. doi:10.1016\/j.vaa.2016.11.002"},{"issue":"4","key":"B16","series-title":"Animals","first-page":"1","article-title":"Electroencephalographic and cardiovascular changes associated with propofol constant rate of infusion anesthesia in young healthy dogs","volume":"13","author":"Murillo C","year":"2023","unstructured":"Murillo C, Weil AB, Moore GE, Kreuzer M, Ko JC. Electroencephalographic and cardiovascular changes associated with propofol constant rate of infusion anesthesia in young healthy dogs. Animals. 2023;13(4):1\u201317. doi:10.3390\/ani13040664"},{"issue":"2","key":"B17","series-title":"Br J Anaesth","first-page":"172","article-title":"Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol","volume":"105","author":"Soehle M","year":"2010","unstructured":"Soehle M, Kuech M, Grube M, et al. Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol. Br J Anaesth. 2010;105(2):172\u2013178. doi:10.1093\/bja\/aeq155"},{"issue":"1","key":"B18","series-title":"Vet Anaesth Analg","first-page":"49","article-title":"The clinical use of the neuromuscular blocking agent rocuronium in dogs","volume":"29","author":"Dugdale AHA","year":"2002","unstructured":"Dugdale AHA, Adams WA, Jones RS. The clinical use of the neuromuscular blocking agent rocuronium in dogs. Vet Anaesth Analg. 2002;29(1):49\u201353. doi:10.1046\/j.1467-2987.2001.00057.x"},{"issue":"3","key":"B19","series-title":"J Vet Med Sci","first-page":"425","article-title":"Effect of sevoflurane anesthesia on neuromuscular blockade produced by rocuronium infusion in dogs","volume":"81","author":"Sakata H","year":"2019","unstructured":"Sakata H, Ishikawa Y, Ishihara G, et al. Effect of sevoflurane anesthesia on neuromuscular blockade produced by rocuronium infusion in dogs. J Vet Med Sci. 2019;81(3):425\u2013433."},{"issue":"3","key":"B20","series-title":"Vet J","first-page":"467","article-title":"Reversal of profound rocuronium or vecuronium-induced neuromuscular block with sugammadex in isoflurane-anaesthetised dogs","volume":"192","author":"Mosing M","year":"2012","unstructured":"Mosing M, Auer U, West E, Jones RS, Hunter JM. Reversal of profound rocuronium or vecuronium-induced neuromuscular block with sugammadex in isoflurane-anaesthetised dogs. Vet J. 2012;192(3):467\u2013471. doi:10.1016\/j.tvjl.2011.08.034"},{"issue":"4","key":"B21","series-title":"Vet Rec Case Reports","first-page":"e437","article-title":"Extremely prolonged neuromuscular blockade following a single dose of rocuronium in a dog","volume":"10","author":"Gomez AG","year":"2022","unstructured":"Gomez AG, Auckburally A, Flaherty D. Extremely prolonged neuromuscular blockade following a single dose of rocuronium in a dog. Vet Rec Case Reports. 2022;10(4):e437. doi:10.1002\/vrc2.437"},{"issue":"4","key":"B22","series-title":"Br J Anaesth","first-page":"473","article-title":"Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey","volume":"96","author":"de Boer HD","year":"2006","unstructured":"de Boer HD, van Egmond J, van de Pol F, Bom A, Booij LHDJ. Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey. Br J Anaesth. 2006;96(4):473\u2013479. doi:10.1093\/bja\/ael013"},{"issue":"3","key":"B23","series-title":"Anesth Analg","first-page":"563","article-title":"Reversal of rocuronium-induced neuromuscular block with the novel drug sugammadex is equally effective under maintenance anesthesia with propofol or sevoflurane","volume":"104","author":"Vanacker BF","year":"2007","unstructured":"Vanacker BF, Saldien V, Kalmar AF, Prins ME. Reversal of rocuronium-induced neuromuscular block with the novel drug sugammadex is equally effective under maintenance anesthesia with propofol or sevoflurane. Anesth Analg. 2007;104(3):563\u2013568. doi:10.1213\/01.ane.0000231829.29177.8e"},{"issue":"4","key":"B24","series-title":"Can J Anesth","first-page":"353","article-title":"Rocuronium pharmacokinetic-pharmacodynamic relationship under stable propofol or isoflurane anesthesia","volume":"49","author":"Dragne, A","year":"2002","unstructured":"Dragne, A, Varin, F, Plaud, B, Donati F. Rocuronium pharmacokinetic-pharmacodynamic relationship under stable propofol or isoflurane anesthesia. Can J Anesth. 2002;49(4):353\u2013360."},{"issue":"5","key":"B25","series-title":"Anesthesiology","first-page":"1004","article-title":"Pharmacodynamic interaction of remifentanil and dexmedetomidine on depth of sedation and tolerance of laryngoscopy","volume":"131","author":"Weerink MAS","year":"2019","unstructured":"Weerink MAS, Barends CRM, Muskiet ERR, et al. Pharmacodynamic interaction of remifentanil and dexmedetomidine on depth of sedation and tolerance of laryngoscopy. Anesthesiology. 2019;131(5):1004\u20131017. doi:10.1097\/ALN.0000000000002882"},{"issue":"3","key":"B26","series-title":"J Vet Intern Med","first-page":"645","article-title":"Qualitative and quantitative characteristics of the electroencephalogram in normal horses after sedation","volume":"26","author":"Williams DC","year":"2012","unstructured":"Williams DC, Aleman M, Tharp B, et al. Qualitative and quantitative characteristics of the electroencephalogram in normal horses after sedation. J Vet Intern Med. 2012;26(3):645\u2013653. doi:10.1111\/j.1939-1676.2012.00921.x"},{"issue":"1","key":"B27","series-title":"Sci Rep","first-page":"246","article-title":"Comparison of bispectral index and patient state index values according to recovery from moderate neuromuscular block under steady-state total intravenous anesthesia","volume":"11","author":"Kim D","year":"2021","unstructured":"Kim D, Ahn JH, Heo G, Jeong JS. Comparison of bispectral index and patient state index values according to recovery from moderate neuromuscular block under steady-state total intravenous anesthesia. Sci Rep. 2021;11(1):246\u2013253. doi:10.1038\/s41598-021-85419-8"},{"issue":"2","key":"B28","series-title":"Anesth Analg","first-page":"488","article-title":"The bispectral index declines during neuromuscular block in fully awake persons","volume":"97","author":"Messner M","year":"2003","unstructured":"Messner M, Beese U, Romst\u00f6ck J, Dinkel M, Tschaikowsky K. The bispectral index declines during neuromuscular block in fully awake persons. Anesth Analg. 2003;97(2):488\u2013491. doi:10.1213\/01.ANE.0000072741.78244.C0"},{"issue":"34","key":"B29","series-title":"Medicine (Baltimore)","first-page":"1","article-title":"Sugammadex for reversal of rocuronium-induced neuromuscular blockade in pediatric patients: a systematic review and meta-analysis","volume":"95","author":"Won YJ","year":"2016","unstructured":"Won YJ, Lim BG, Lee DK, Kim H, Kong MH, Lee IO. Sugammadex for reversal of rocuronium-induced neuromuscular blockade in pediatric patients: a systematic review and meta-analysis. Medicine (Baltimore). 2016;95(34):1\u20137. doi:10.1097\/MD.0000000000004678"},{"issue":"4","key":"B30","series-title":"Anaesth Intensive Care","first-page":"440","article-title":"Symposium\u2013muscle relaxants in paediatric anesthesia","volume":"18","author":"Meretoja O","year":"1990","unstructured":"Meretoja O. Symposium\u2013muscle relaxants in paediatric anesthesia. Anaesth Intensive Care. 1990;18(4):440\u2013448."},{"key":"B31","series-title":"Core Evid","first-page":"57","article-title":"Sugammadex as a reversal agent for neuromuscular block: an evidence-based review","volume":"8","author":"Schaller SJ","year":"2013","unstructured":"Schaller SJ, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evid. 2013;8:57-67. doi:10.2147\/CE.S35675"},{"issue":"3","key":"B32","series-title":"Neurol Res","first-page":"313","article-title":"EEG abnormalities during treatment with tadalafil, a phosphodiesterase type 5 inhibitor","volume":"31","author":"Okuyucu EE","year":"2009","unstructured":"Okuyucu EE, Guven O, Duman T, et al. EEG abnormalities during treatment with tadalafil, a phosphodiesterase type 5 inhibitor. Neurol Res. 2009;31(3):313\u2013315. doi:10.1179\/174313209X382548"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.23.03.0050\/ajvr.23.03.0050.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.23.03.0050\/ajvr.23.03.0050.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.23.03.0050\/ajvr.23.03.0050.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T12:01:47Z","timestamp":1685448107000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.23.03.0050\/ajvr.23.03.0050.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":32,"URL":"https:\/\/doi.org\/10.2460\/ajvr.23.03.0050","relation":{},"ISSN":["0002-9645"],"issn-type":[{"value":"0002-9645","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,31]]}}}