Document Detail


Heart rate and blood pressure variability as markers of sensory blockade with labour epidural analgesia.
MedLine Citation:
PMID:  17331929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the correlation between the progression of somatosensory blockade and changes in autonomic outflow following the onset of labour epidural analgesia. METHODS: Twelve labouring parturients consented to participate in the study. Baseline electrocardiogram, blood pressure (BP) and respiratory rate were recorded for ten minutes. The epidural consisted of 0.125% bupivacaine with 50 microg of fentanyl (total volume 20 mL). Measurements were repeated for ten minutes after initiation of the block. The level of sensory block was measured bilaterally with loss of sensation to ice at two-minute intervals. Wavelet transform was used to obtain heart rate (HR) and BP variability every two minutes following the loading dose of epidural medication. High frequency power of HR variability was used to assess changes in parasympathetic activity. The total power of BP variability was used to assess changes in sympathetic activity. A nonparametric repeated measures ANOVA was used for the variability data, and a Spearman rank correlation test was used to evaluate the relationship between the sensory block and HR and BP variability. RESULTS: The sensory block progressed to T9 at ten minutes post-epidural and was the mirror image of the decrease in total power of BP variability. High frequency power of HR variability increased to a plateau at six minutes post-epidural. A significant correlation was found between the increase in sensory block and the observed decrease in BP variability (r = -1.000, P = 0.0028). CONCLUSION: In this study of labouring parturients, BP variability correlated with the progression of both sympathetic and somatosensory block following epidural anesthesia, while HR variability was shown to be a surrogate marker of increased parasympathetic activity.
Authors:
Alain Deschamps; Ian Kaufman; Alana Geist; Steven S B Backman; Karen Loo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  54     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-02     Completed Date:  2007-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  183-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Montreal Heart Institute, 5000 Bélanger Street, Montreal, Quebec H1T 1C8, Canada. a.deschamps@umontreal.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Epidural*
Analgesia, Obstetrical*
Analysis of Variance
Blood Pressure / drug effects*,  physiology
Female
Heart Rate / drug effects*,  physiology
Humans
Monitoring, Intraoperative
Parasympathetic Nervous System / drug effects,  physiology
Pregnancy
Respiration / drug effects
Respiratory Mechanics / physiology
Sympathetic Nervous System / drug effects,  physiology
Time Factors

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


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