Document Detail

Heart rate variability and the prone position under general versus spinal anesthesia.
MedLine Citation:
PMID:  9873967     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To evaluate heart rate (HR) variability in the prone position with power spectral heart rate (PSHR) analysis during spinal and general anesthesia. DESIGN: Prospective, clinical evaluation of HR variability in the prone position. SETTING: Tertiary care teaching hospital. PATIENTS: 20 healthy, ASA physical status I and II patients scheduled for elective lumbar spine surgery in the prone position. INTERVENTIONS: Anesthetic technique was either a standard general anesthetic or spinal anesthetic, based on the preference of the patient. Power spectral heart rate, HR, and blood pressure (BP) readings were determined prior to anesthetic intervention and as soon as a stable PSHR reading was available in the prone position. MEASUREMENTS AND MAIN RESULTS: Heart rate and BP were recorded at baseline prior to anesthesia and at the time of stable PSHR data in the prone position. Power spectral heart rate data included low-frequency activity (LFa), high-frequency activity (HFa), and the ratio (LFa/HFa). Spinal anesthesia level was recorded by thoracic dermatome at complete onset. Data were collected from 20 patients; 12 patients chose spinal anesthesia and 8 chose general anesthesia. The prone position resulted in significant increase in HR in the spinal group and significant decrease in BP in the general anesthesia group. Low-frequency activity and LFa/HFa ratio were unchanged in the spinal anesthesia group and were significantly decreased in the general anesthesia group. Spinal level was T8.7. CONCLUSIONS: The association of less change in LFa activity and preservation of BP on assumption of the prone position in patients during low spinal anesthesia suggests better preservation of autonomic nervous system compensatory mechanisms during low spinal anesthesia than with general anesthesia.
J E Tetzlaff; J F O'Hara; H J Yoon; A Schubert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  10     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-03-11     Completed Date:  1999-03-11     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:  656-9     Citation Subset:  IM    
Department of General Anesthesiology, Cleveland Clinic Foundation, OH 44195, USA.
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MeSH Terms
Anesthesia, General*
Anesthesia, Spinal*
Anesthetics, Inhalation / administration & dosage
Anesthetics, Intravenous / administration & dosage
Anesthetics, Local / administration & dosage
Autonomic Nervous System / physiology
Blood Pressure / physiology
Bupivacaine / administration & dosage
Heart Rate / physiology*
Isoflurane / administration & dosage
Lumbar Vertebrae / surgery
Neuromuscular Depolarizing Agents / administration & dosage
Neuromuscular Nondepolarizing Agents / administration & dosage
Nitrous Oxide / administration & dosage
Prone Position / physiology*
Prospective Studies
Signal Processing, Computer-Assisted
Succinylcholine / administration & dosage
Surgical Procedures, Elective
Thiopental / administration & dosage
Tubocurarine / administration & dosage
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 0/Neuromuscular Depolarizing Agents; 0/Neuromuscular Nondepolarizing Agents; 10024-97-2/Nitrous Oxide; 2180-92-9/Bupivacaine; 26675-46-7/Isoflurane; 306-40-1/Succinylcholine; 57-95-4/Tubocurarine; 76-75-5/Thiopental

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