Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep

The purpose of this study was to evaluate the effects of lumbar myelography on subarachnoid pressure, cardiorespiratory parameters and pressure-volume index in sheep. Eight sheep were evaluated. The animals were submitted to puncture of the cisterna magna for monitoring of subarachnoid pressure (SaP). Lumbar myelography was performed through applying Iohexol (0.4mL/kg). T^oC, PAS, PAD, MAP, InspISO, FeISO, SaP and CPP were recorded immediately after anesthetic stabilization (M0), during lumbar puncture (M1), and two, four and six minutes after contrast application (M2, M3 and M4, respectively). Blood pressure initially increased, then decreased, returning to basal level, similarly observed for InspISo and FeISo. The SaP rose initially thereafter remaining stable. Despite of the effect on subarachnoid pressure, lumbar myelography can be considered safe in sheep.

INDEX TERMS:
Lumbar; myelography; subarachnoid pressure; cardiorespiratory parameter; sheep; neuroradiology; intercranial pressure; ovine; pressure-volume index

Authorship

Bruno W. Minto

Departamento de Clínica Veterinária, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp), Via de Acesso Prof. Paulo Donato Castellane, Vila Industrial, Jaboticabal, SP 14884-900, Brazil.Universidade Estadual PaulistaBrazilJaboticabal, SP, BrazilDepartamento de Clínica Veterinária, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp), Via de Acesso Prof. Paulo Donato Castellane, Vila Industrial, Jaboticabal, SP 14884-900, Brazil.

Luciane R. Mesquita ^**Corresponding author: lrmesquita@yahoo.com.br

Departamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp), Rua Prof. Dr. Valter Corrêa s/n, Botucatu, SP 18618-681, Brazil.Universidade Estadual PaulistaBrazilBotucatu, SP, BrazilDepartamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp), Rua Prof. Dr. Valter Corrêa s/n, Botucatu, SP 18618-681, Brazil.

http://orcid.org/0000-0003-3853-7084

João A.L. Souza

Gabriela M. Bueno

Luís G. Faria

Fernando Y.K. Kawamoto

Diego Yamada

Luis C. Marques

*Corresponding author: lrmesquita@yahoo.com.br

Conflict of interest statement.- The authors have no competing interests.

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables | Formulas

Figures (2)
Tables (5)
Formulas (1)

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Fig.1.
Graphical representation of the polynomial trend line of the variables HR = heart rate (blue lines and traces), MAP = mean blood pressure (red lines and points), SaP = subarachnoid pressure (yellow lines and cross) and CPP = cerebral perfusion pressure (purple lines and X) of the experimental model of ovine submitted to lumbar myelography and measurement of subarachnoid pressure.

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Fig.2.
Pressure-volume indexes (PVI) graphically plotted against body weight. The trend line obtained by linear regression, showing the resulting straight-line equation, as well as the Pearson and p.

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Table 1.
Mean and standard deviation and Tukey’s test of body temperature (T^oC), respiratory rate (RR), heart rate (HR), systolic blood pressure (PAS), diastolic blood pressure (PAD), mean blood pressure (PAM), expired fraction of carbon dioxide (EtCO₂), oxygen saturation (SpO₂), inhaled Isoflurane concentrations (InspISO), exhaled Isoflurane concentrations (FeISO), subarachnoid pressure (SaP) and cerebral perfusion pressure (CPP) of the experimental model of ovine submitted to lumbar myelography and subarachnoid pressure

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Table 2.
Pearson correlation among the variables body temperature (T^oC), respiratory rate (RR), heart rate (HR), diastolic blood pressure (PAD), mean blood pressure (PAM), expired fraction of carbon dioxide (EtCO₂), oxygen saturation (SpO₂), inhaled Isoflurane concentrations (InspISO), exhaled Isoflurane concentrations (FeISO), subarachnoid pressure (SaP) and cerebral perfusion pressure (CPP), exposing the r value of the experimental model of ovine submitted to lumbar myelography and pressure gauging subarachnoid

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Table 3.
Mean and standard deviation of the variables body weight, measured length of nuchal ridge to iliac tuberosity, infused contrast volume, pressure volume-index (PVI), subarachnoid pressure (Sap0) and maximum subarachnoid pressure (SaPmax), obtained from the experimental model of ovine submitted to lumbar myelography and gauging subarachnoid pressure

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Table 4.
Pearson correlation between the variables: body weight, length, contrast volume and pressure volume-index (PVI) exposing the r value of the experimental model of ovine submitted to lumbar myelography and subarachnoid pressure measurement

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Table 5.
Relation of pressure volume-index (PVI) values, body weight, contrast volume and dose required to increase maximal subarachnoid pressure (SaPmax) at 40, 50 and 60mmHg as a theoretical limit of pressure of the experimental model of ovine submitted to lumbar myelography and check of subarachnoid pressure

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Fig.1. Graphical representation of the polynomial trend line of the variables HR = heart rate (blue lines and traces), MAP = mean blood pressure (red lines and points), SaP = subarachnoid pressure (yellow lines and cross) and CPP = cerebral perfusion pressure (purple lines and X) of the experimental model of ovine submitted to lumbar myelography and measurement of subarachnoid pressure.

Fig.2. Pressure-volume indexes (PVI) graphically plotted against body weight. The trend line obtained by linear regression, showing the resulting straight-line equation, as well as the Pearson and p.

Table 1. Mean and standard deviation and Tukey’s test of body temperature (T^oC), respiratory rate (RR), heart rate (HR), systolic blood pressure (PAS), diastolic blood pressure (PAD), mean blood pressure (PAM), expired fraction of carbon dioxide (EtCO₂), oxygen saturation (SpO₂), inhaled Isoflurane concentrations (InspISO), exhaled Isoflurane concentrations (FeISO), subarachnoid pressure (SaP) and cerebral perfusion pressure (CPP) of the experimental model of ovine submitted to lumbar myelography and subarachnoid pressure

Moment	T^o (^oC)	RR (MPM)	HR (BPM)	PAS (mmHg)	PAD (mmHg)	PAM (mmHg)	EtCO₂ (mmHg)	SpO₂ (%)	InspISO (%)	FeISO (%)	SaP (mmHg)	CPP (mmHg)
M0	37.58	9.25	107.38	89.00	62.38	76.13	41.25	97.50	1.56	1.08	11.13	65.00
M0	(±1.05)A	(±2.19)A	(±14.62)A	(± 11.86)A	(±12.76)A	(±11.75)A	(±2.76)A	(±1.06)A	(±0.09)A	(±0.1)A	(±4.15)A	(±12.11)AB
M1	37.01	10.00	118.87	121.00	92.1	105.25	42.63	97.38	1.71	1.31	101.88	3.38
M1	(±1.05)B	(±1.85)A	(±26.40)A	(±26.79)C	(±24.38)C	(±24.81)B	(±3.46)A	(±0.74)A	(±0.14)B	(±0.15)B	(±22.53)C	(±13.85)C
M2	36.94	9.88	112.38	107.38	82.75	90.25	42.75	97.38	1.71	1.28	43.13	47.13
M2	(±0.93)BC	(±2.16)A	(±23.27)A	(±21.77)BC	(±21.76)BC	(±20.35)A	(±4.13)A	(±0.91)A	(±0.12)B	(±0.15)B	(±9.94)B	(±22.06)B
M3	36.85	9.88	108.00	100.88	75.38	85.88	41.13	97.00	1.76	1.31	19.13	66.75
M3	(±0.96)BC	(±1.95)A	(±21.98)A	(±18.90)AB	(±19.28)AB	(±21.07)A	(±4.32)A	(±0.92)A	(±0.14)B	(±0.14)B	(±3.44)A	(±23.34)A
M4	36.83	9.88	108.25	99.38	74.50	85.75	42.13	97.38	1.76	1.31	15.25	70.50
M4	(±0.97)C	(±1.95)A	(±23.37)A	(±22.26)AB	(±19.53)AB	(±20.21)A	(±3.83)A	(±0.74)A	(±0.15)B	(±0.17)B	(±5.06)A	(±22.03)A

A,B,C = different letters in the same column indicate statistical difference at 5% by the Tukey test.

Table 2. Pearson correlation among the variables body temperature (T^oC), respiratory rate (RR), heart rate (HR), diastolic blood pressure (PAD), mean blood pressure (PAM), expired fraction of carbon dioxide (EtCO₂), oxygen saturation (SpO₂), inhaled Isoflurane concentrations (InspISO), exhaled Isoflurane concentrations (FeISO), subarachnoid pressure (SaP) and cerebral perfusion pressure (CPP), exposing the r value of the experimental model of ovine submitted to lumbar myelography and pressure gauging subarachnoid

	T^o	RR	HR	PAS	PAD	PAM	EtCO₂	SpO₂	InspISO	FeISO	SaP	CPP
T^o	1
RR	-0.327*£	1
HR	-0.286	0.538*§	1
PAS	0.133	-0.618*§	-0.032	1
PAD	0.209	-0.629*§	-0.091	0.932*∂	1
PAM	0.183	-0.683*§	-0.134	0.967*∂	0.942*∂	1
EtCO2	0.212	0.197	0.231	0.047	0.026	0.018	1
SpO2	0.060	0.260	0.316*£	-0.054	-0.152	-0.125	0.482*§	1
InspISO	0.051	0.174	0.009	0.104	0.117	0.050	0.414*§	0.177	1
FeISO	-0.172	0.298	-0.127	-0.073	-0.024	-0.086	0.107	-0.008	0.752*∂	1
Sap	-0.070	0.011	0.167	0.536*§	0.468*§	0.505*§	0.058	0.075	-0.012	0.134	1
CPP	0.206	-0.481*§	-0.286	0.045	0.106	0.103	-0.054	-0.173	0.049	-0.213	-0.806*∂	1

£ = Weak correlation r<0.39, § = moderate correlation r>0.4<0.69, ∂ = strong correlation r>0.7<1.0; * significative values 5%, in these the superscript symbol represents the strength of the correlation.

Table 3. Mean and standard deviation of the variables body weight, measured length of nuchal ridge to iliac tuberosity, infused contrast volume, pressure volume-index (PVI), subarachnoid pressure (Sap0) and maximum subarachnoid pressure (SaPmax), obtained from the experimental model of ovine submitted to lumbar myelography and gauging subarachnoid pressure

Variable	Mean	Standard deviation
Body weight (kg)	44.68	±5.76
Lenght (cm)	78.87	±5.64
Volume (mL)	17.87	±2.30
PVI (mL)	17.91	±3.62
Sap0 (mmHg)	11.12	±4.16
Sapmax (mmHg)	101.87	±22.54

Table 4. Pearson correlation between the variables: body weight, length, contrast volume and pressure volume-index (PVI) exposing the r value of the experimental model of ovine submitted to lumbar myelography and subarachnoid pressure measurement

	Body weight	Lenght	Volume	PVI
Body weight	1
Lenght	0.491	1
Volume	1*^∂	0.491	1
PVI	0.756*^∂	0.410	0.756*^∂	1

£ = Weak correlation r<0.39, § = moderate correlation r>0.4<0.69, ∂ = strong correlation r>0.7<1.0; * significative values 5%, in these the superscript symbol represents the strength of the correlation.

Table 5. Relation of pressure volume-index (PVI) values, body weight, contrast volume and dose required to increase maximal subarachnoid pressure (SaPmax) at 40, 50 and 60mmHg as a theoretical limit of pressure of the experimental model of ovine submitted to lumbar myelography and check of subarachnoid pressure

Body weight	PVI	SaPmax 40mmHg		SaPmax 50mmHg		SaPmax 60mmHg
kg	mL	mL	mL/kg	mL	mL/kg	mL	mL/kg
30	10.98	6.10	0.20	7.17	0.24	8.04	0.27
32	11.89	6.61	0.21	7.76	0.24	8.70	0.27
34	12.80	7.12	0.21	8.36	0.25	9.37	0.28
36	13.71	7.62	0.21	8.95	0.25	10.04	0.28
38	14.62	8.13	0.21	9.55	0.25	10.70	0.28
40	15.53	8.64	0.22	10.14	0.25	11.37	0.28
42	16.45	9.14	0.22	10.74	0.26	12.04	0.29
44	17.36	9.65	0.22	11.33	0.26	12.71	0.29
46	18.27	10.16	0.22	11.93	0.26	13.37	0.29
48	19.18	10.66	0.22	12.52	0.26	14.04	0.29
50	20.09	11.17	0.22	13.12	0.26	14.71	0.29
52	21.00	11.68	0.22	13.71	0.26	15.37	0.30
54	21.91	12.18	0.23	14.31	0.26	16.04	0.30
56	22.83	12.69	0.23	14.90	0.27	16.71	0.30
58	23.74	13.20	0.23	15.50	0.27	17.38	0.30
60	24.65	13.70	0.23	16.09	0.27	18.04	0.30

P V I (m L) = \frac{Δ V (m L)}{\log_10 □ [\frac{S a P \max (m m H g)}{S a p 0 (m m H g)}]}

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Effects of lumbar myelography on subarachnoid pressure and cardiorespiratory parameters in healthy sheep

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[1] *Corresponding author: lrmesquita@yahoo.com.br