Document Detail

Changes in heart rate variability in sevoflurane and nitrous oxide anesthesia: effects of respiration and depth of anesthesia.
MedLine Citation:
PMID:  12031752     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To quantify the effects of sevoflurane on autonomic nerve function by analyzing changes in heart rate (HR) variability in sevoflurane anesthesia; and to investigate the effects of anesthetic depth and apnea on HR variability. DESIGN: Prospective study. SETTING: Operating room (OR) of a university medical center. PATIENTS: 7 ASA physical status I and II patients scheduled for elective surgery. INTERVENTIONS: Patients were premedicated with ranitidine 150 mg. Anesthesia was induced with thiopental sodium 4 mg/kg intravenously (IV) and succinylcholine 1 mg/kg IV, and maintained with nitrous oxide (N(2)O) 67% and sevoflurane in oxygen. Patients were ventilated mechanically at a rate of 15 breaths/min. MEASUREMENTS: R-R interval of electrocardiography (ECG), electroencephalogram (EEG), noninvasive arterial blood pressure (BP), and end-tidal sevoflurane concentration were recorded. Measurements were performed 1) after patients arrived at the OR and were placed in the supine position, 2) a stable period after inhalation of 2% sevoflurane, and 3) following the appearance of an isoelectric EEG at a higher concentration of sevoflurane. At times 2) and 3), data were recorded during mechanical ventilation and during apnea. MAIN RESULTS: There were decreases in both the low-frequency (LF; 0.04 to 0.15 Hz) and high-frequency (HF; 0.15 to 0.4 Hz) components of HR variability during anesthesia compared with the awake state. HF decreased during apnea at 2% sevoflurane, but LF did not change. Neither LF nor HF changed in response to the absence or presence of respiration during isoelectric EEG. CONCLUSIONS: Autonomic nerve activity was attenuated by sevoflurane. Parasympathetic input to the heart by respiration was markedly suppressed following the appearance of isoelectric EEG.
Itsuo Nakatsuka; Ryoichi Ochiai; Junzo Takeda
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  14     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-28     Completed Date:  2002-12-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-200     Citation Subset:  IM    
Department of Anesthesiology, School of Medicine, Keio University, Tokyo, Japan.
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MeSH Terms
Anesthetics, Inhalation / pharmacology*
Apnea / chemically induced
Blood Pressure / drug effects
Electroencephalography / drug effects
Heart Rate / drug effects*
Hospitals, University
Methyl Ethers / pharmacology*
Nitrous Oxide / pharmacology*
Operating Rooms
Prospective Studies
Reference Values
Respiration / drug effects*
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 10024-97-2/Nitrous Oxide; 28523-86-6/sevoflurane

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