Abstract：
OBJECTIVE: To examine whether increased systemic arterial blood pressure (ABP) and decreased heart rate (HR) under inhalant anesthesia were suggestive of the Cushing reflex (CR) in dogs with neurological diseases based on magnetic resonance imaging (MRI) findings.
METHODS: Retrospective case-control study.
METHODS: A sample of 137 client-owned dogs admitted to two veterinary teaching hospitals for diagnosis and patient care owing to suspected intracranial disease from 2005 to 2020. All dogs underwent general anesthesia for MRI of the brain.
METHODS: Based on MRI study reports, dogs were divided into three study groups: group A, dogs with suspected brain herniation; group B, dogs with an abnormal MRI finding but without suspicion of herniation; and group C, dogs with structurally unremarkable brains (control). Initial evaluation by an anesthesiologist resulted in 58 cases selected for further review based on suspicion of having intracranial hypertension, as indicated by ABP and HR changes under anesthesia. Anesthetic records were randomized and independently reviewed by three board-certified anesthesiologists blinded to MRI diagnosis who allocated each dog into one of three groups: 1) likely to have CR; 2) unlikely to have CR; or 3) insufficient data for determination.
RESULTS: Of the 58 cases evaluated, nine were considered likely to have CR and 48 were considered unlikely to have CR. In one case, the anesthesiologists were unable to determine whether CR occurred. Of the nine dogs with likely CR, three had an MRI diagnosis of intracranial herniation. The remaining six dogs suspected of CR belonged to the normal brain group.
CONCLUSIONS: The ABP and HR changes associated with CR are not reliably associated with brain herniation in dogs undergoing general anesthesia.
METHODS: Retrospective case-control study.
METHODS: A sample of 137 client-owned dogs admitted to two veterinary teaching hospitals for diagnosis and patient care owing to suspected intracranial disease from 2005 to 2020. All dogs underwent general anesthesia for MRI of the brain.
METHODS: Based on MRI study reports, dogs were divided into three study groups: group A, dogs with suspected brain herniation; group B, dogs with an abnormal MRI finding but without suspicion of herniation; and group C, dogs with structurally unremarkable brains (control). Initial evaluation by an anesthesiologist resulted in 58 cases selected for further review based on suspicion of having intracranial hypertension, as indicated by ABP and HR changes under anesthesia. Anesthetic records were randomized and independently reviewed by three board-certified anesthesiologists blinded to MRI diagnosis who allocated each dog into one of three groups: 1) likely to have CR; 2) unlikely to have CR; or 3) insufficient data for determination.
RESULTS: Of the 58 cases evaluated, nine were considered likely to have CR and 48 were considered unlikely to have CR. In one case, the anesthesiologists were unable to determine whether CR occurred. Of the nine dogs with likely CR, three had an MRI diagnosis of intracranial herniation. The remaining six dogs suspected of CR belonged to the normal brain group.
CONCLUSIONS: The ABP and HR changes associated with CR are not reliably associated with brain herniation in dogs undergoing general anesthesia.
摘要：
目的：根据磁共振成像（MRI）检查吸入麻醉下全身动脉血压（ABP）升高和心率（HR）降低是否提示神经疾病犬的库欣反射（CR）。
方法：回顾性病例对照研究。
方法：2005年至2020年因怀疑颅内疾病而在两家兽医教学医院接受诊断和患者护理的137只客户拥有的狗的样本。所有的狗都接受了全麻的脑MRI。
方法：根据MRI研究报告，狗分为三个研究组：A组，疑似脑疝的狗；B组，MRI发现异常但不怀疑疝的狗；和C组，大脑结构不显著的狗（对照）。麻醉师的初步评估导致58例因怀疑患有颅内高压而被选择进行进一步检查。如麻醉下ABP和HR变化所示。麻醉记录由三名不知道MRI诊断的董事会认证的麻醉师随机和独立审查，他们将每只狗分为三组之一：1）可能有CR；2）不太可能有CR；或3）确定数据不足。
结果：在评估的58例中，9人被认为可能有CR,48人被认为不太可能有CR.在一个案例中,麻醉医师无法确定是否发生CR.在九只可能有CR的狗中，其中3人的MRI诊断为颅内疝.其余6只疑似CR犬属于正常脑组。
结论：在接受全身麻醉的狗中，与CR相关的ABP和HR变化与脑疝并不可靠相关。
方法：回顾性病例对照研究。
方法：2005年至2020年因怀疑颅内疾病而在两家兽医教学医院接受诊断和患者护理的137只客户拥有的狗的样本。所有的狗都接受了全麻的脑MRI。
方法：根据MRI研究报告，狗分为三个研究组：A组，疑似脑疝的狗；B组，MRI发现异常但不怀疑疝的狗；和C组，大脑结构不显著的狗（对照）。麻醉师的初步评估导致58例因怀疑患有颅内高压而被选择进行进一步检查。如麻醉下ABP和HR变化所示。麻醉记录由三名不知道MRI诊断的董事会认证的麻醉师随机和独立审查，他们将每只狗分为三组之一：1）可能有CR；2）不太可能有CR；或3）确定数据不足。
结果：在评估的58例中，9人被认为可能有CR,48人被认为不太可能有CR.在一个案例中,麻醉医师无法确定是否发生CR.在九只可能有CR的狗中，其中3人的MRI诊断为颅内疝.其余6只疑似CR犬属于正常脑组。
结论：在接受全身麻醉的狗中，与CR相关的ABP和HR变化与脑疝并不可靠相关。
