Document Detail


Altered autonomic cardiovascular regulation after combined deep and superficial cervical plexus blockade for carotid endarterectomy.
MedLine Citation:
PMID:  16931657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Compromised cardiac autonomic modulation can produce cardiovascular disturbances. We investigated whether combined deep and superficial cervical plexus (CP) blockade for carotid endarterectomy (CEA) produces changes in autonomic cardiovascular regulation. To estimate alterations in cardiovascular autonomic control before and after combined CP blockade in 22 patients undergoing CEA, the heart rate (HR) variability, systolic blood pressure (SBP) variability, and baroreflex sensitivity were analyzed. We found that SBP (157 +/- 28 mm Hg versus 191 +/- 38 mm Hg before and after combined CP blockade, respectively) and HR (68 +/- 10 bpm versus 84 +/- 9 bpm) increased after combined CP blockade. The high frequency power of HR variability (3.7 +/- 0.9 versus 2.2 +/- 1.2 ln/ms2) decreased (decrease in parasympathetic drive), whereas the low frequency power of SBP variability (5.5 +/- 4.7 versus 8.6 +/- 9.4 mm Hg2) increased (increase in vascular sympathetic outflow). Baroreflex sensitivity decreased, and this decrease was negatively correlated with a SBP increase (r = -0.455). The present results suggest that combined CP blockade impairs autonomic cardiovascular homeostasis and suggests an association between combined CP blockade and intraoperative or postoperative adverse cardiovascular events in high-risk cardiac patients undergoing CEA that merits further studies.
Authors:
Young-Kug Kim; Gyu-Sam Hwang; In-Young Huh; Jai-Hyun Hwang; Jong-Yeon Park; Sung-Lyang Chung; Tae-Won Kwon; Sung-Min Han
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  103     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-25     Completed Date:  2006-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amides / pharmacology
Anesthetics, Local / pharmacology
Arrhythmias, Cardiac / etiology*,  pathology
Blood Pressure / drug effects
Bronchodilator Agents / pharmacology
Cardiovascular System / drug effects
Cervical Plexus / pathology
Endarterectomy, Carotid / adverse effects*,  methods*
Epinephrine / pharmacology
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Amides; 0/Anesthetics, Local; 0/Bronchodilator Agents; 51-43-4/Epinephrine; 84057-95-4/ropivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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