Abstract
The aim of the study was to develop a multifactorial tool for assessment of sedation in dogs. Following a modified Delphi method, thirty-eight veterinary anaesthetists were contacted to describe the following levels of awareness: no-sedation, light, moderate, profound sedation and excitation. The answers were summarized in descriptors for each level. A questionnaire was created with all the variables obtained from the descriptors. The questionnaire was returned to the panel of anaesthetists to be used before and after real sedations in conjunction with the previous 5-point categorical scale. Data obtained were analysed using the classification-tree and random-forest methods. Twenty-three anaesthetists (60%) replied with descriptions. The descriptors and study variables were grouped in categories: state-of-mind, posture, movements, stimuli-response, behaviour, response-to-restraint, muscle tone, physiological data, facial-expression, eye position, eyelids, pupils, vocalization and feasibility-to-perform-intended-procedure. The anaesthetists returned 205 completed questionnaires. The levels of awareness reported by the anaesthetists were: no sedation in 92, mild (26), moderate (37) and profound in 50 cases. The classification-tree detected 6 main classifying variables: change in posture, response-to-restraint, head-elevation, response-to-toe-pinching, response-to-name, and movements. The random-forest found that the following variables: change in posture, response-to-restraint, head-elevation, response-to-name, movements, posture, response-to-toe-pinching, demeanour, righting-reflex and response-to-handclap, were classified correctly in 100% awake, 62% mild, 70% moderate and 86% of profound sedation cases. The questionnaire and methods developed here classified correctly the level of sedation in most cases. Further studies are needed to evaluate the validity of this tool in the clinical and research setting.
Highlights
Sedation is a state characterized by central depression accompanied by drowsiness and some degree of centrally induced relaxation [1]
A modified Delphi method was used to obtain the opinions of anaesthetists working in clinical practice [8]
Thirty-eight full-time veterinary anaesthetists were contacted to explore their interest to be part of the expert panel. They all spoke Spanish as their mother language, were members of the SEAAV (Sociedad Española de Anestesia y Analgesia Veterinaria, Spanish for Spanish Society of Veterinary Anaesthesia and Analgesia), and had postgraduate training in veterinary
Summary
Sedation is a state characterized by central depression accompanied by drowsiness and some degree of centrally induced relaxation [1]. The term is very broad and it is regularly used to refer to a range from a calm and stress-free state required just to tolerate hospitalization, to a much more profound depression of the central nervous system with immobility and no response to painful stimulus. The assessment of the degree of sedation experienced by animals is fundamental both in clinical practice and in research. This assessment can enhance the accurate titration of anaesthetic agents to reduce the incidence of excessive drug-induced complications [2]. It can be a fundamental tool in the development of new sedative drugs, drug combinations and routes of administration
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