Document Detail


Different effects on circulatory control during volatile induction and maintenance of anesthesia and total intravenous anesthesia: autonomic nervous activity and arterial cardiac baroreflex function evaluated by blood pressure and heart rate variability analysis.
MedLine Citation:
PMID:  16563324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate the different effects on autonomic circulatory control during volatile induction/maintenance of anesthesia (VIMA) vs total intravenous anesthesia (TIVA). DESIGN: Prospective study. SETTING: Operating theater of a university hospital. PATIENTS: Twenty patients, with American Society of Anesthesiologists physical status of I or II, were randomly allocated into the VIMA group (n = 10) or the TIVA group (n = 10). INTERVENTIONS: In the VIMA group, anesthesia was induced with 5% sevoflurane and 60% N2O in oxygen and maintained with 2% sevoflurane and 60% N2O in oxygen. In the TIVA group, anesthesia was induced with propofol 2.0 mg/kg intravenously by bolus injection and fentanyl 2 microg/kg, and maintained with an intravenous infusion of propofol 5 mg/kg.per hour and air-oxygen mixture. MEASUREMENTS: Monitoring included recordings of electrocardiographic and arterial blood pressure waveforms. Autonomic nervous activity and arterial cardiac baroreflex function were evaluated by analysis of blood pressure variability, heart rate variability, and transfer function analysis between these 2 variables. MAIN RESULTS: In the VIMA group, the low-frequency component of blood pressure variability (LF(SBP)) and low- and high-frequency components of the R-R interval variability (LF(RR) and HF(RR)) decreased significantly during anesthesia. In the TIVA group, LF(SBP) and LF(RR) decreased significantly. The degree of reduction in LF(SBP) was greater in the VIMA group than in the TIVA group. However, changes in R-R interval variability and cardiac baroreflex indices were not significantly different between the 2 groups. CONCLUSIONS: Our results demonstrated that although reductions in autonomic nervous modulation to the heart might not be so different between the 2 groups, reduction in sympathetic nervous modulation to peripheral vasculature is greater in the VIMA group than in the TIVA group.
Authors:
Yojiro Ogawa; Kenichi Iwasaki; Shigeki Shibata; Jitsu Kato; Setsuro Ogawa; Yoshiyuki Oi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-27     Completed Date:  2006-09-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-95     Citation Subset:  IM    
Affiliation:
Department of Dental Anesthesiology, Nihon University School of Dentistry, Tokyo 101-8310, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Inhalation*
Anesthesia, Intravenous*
Autonomic Nervous System / drug effects*
Baroreflex / drug effects*
Blood Pressure / drug effects
Electrocardiography / drug effects
Female
Fourier Analysis
Heart / drug effects
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Male
Middle Aged

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


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