Heart rate variability does not discriminate between different levels of haemodynamic responsiveness during surgical anaesthesia

Luginbühl, M; Yppärilä-Wolters, H; Rüfenacht, M; Petersen-Felix, S; Korhonen, I (2007). Heart rate variability does not discriminate between different levels of haemodynamic responsiveness during surgical anaesthesia. British journal of anaesthesia, 98(6), pp. 728-36. Oxford: Oxford University Press 10.1093/bja/aem085

[img]
Preview
Text
aem085.pdf - Published Version
Available under License Publisher holds Copyright.

Download (564kB) | Preview

BACKGROUND: Hypnotic depth but not haemodynamic responsiveness is measured with EEG-based monitors. In this study we compared heart rate variability (HRV) in unstimulated patients and stimulation-induced HRV at different levels of anaesthesia. METHODS: A total of 95 ASA I or II patients were randomly assigned to five groups (Group 1: BIS 45(5), remifentanil 1 ng ml(-1); Group 2: BIS 45(5), remifentanil 2 ng ml(-1); Group 3: BIS 45(5), remifentanil 4 ng ml(-1); Group 4: BIS 30(5), remifentanil 2 ng ml(-1); Group 5: BIS 60(5), remifentanil 2 ng ml(-1)). A time- and frequency-domain analysis of the RR interval (RRI) from the electrocardiogram was performed. HRV before induction, before and after a 5 s tetanic stimulus of the ulnar nerve, and before and after tracheal intubation was compared between groups, between stimuli, and between responders to intubation [systolic arterial pressure (SAP) increase >20 mm Hg, a maximal heart rate (HR) after intubation >90 min(-1) or both] and non-responders (anova). RESULTS: Induction of anaesthesia significantly lowered HR and HRV. Mean RRI before stimulation was higher in G3 than in G1, G2, and G4 (P < 0.001), whereas the other HRV parameters were similar. Intubation induced a greater HRV response than tetanic stimulation. The mean RRI after intubation was lower in G3 compared with the other groups and the sd of the RRI after tetanic stimulation was lower in G3 compared with G5. Otherwise, unstimulated HRV and stimulation-induced HRV were similar in responders and non-responders. CONCLUSION: HRV parameters discriminate between awake and general anaesthesia, are different after tracheal intubation and a 5 s ulnar nerve stimulation, but do not discriminate between different levels of haemodynamic responsiveness during surgical anaesthesia.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Luginbühl, Martin

ISSN:

0007-0912

ISBN:

17468493

Publisher:

Oxford University Press

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 14:57

Last Modified:

27 Apr 2018 11:04

Publisher DOI:

10.1093/bja/aem085

PubMed ID:

17468493

Web of Science ID:

000247208300005

BORIS DOI:

10.7892/boris.24567

URI:

https://boris.unibe.ch/id/eprint/24567 (FactScience: 51537)

Actions (login required)

Edit item Edit item
Provide Feedback