Document Detail

Linear and nonlinear analysis of heart rate variability during propofol anesthesia for short-duration procedures in children.
MedLine Citation:
PMID:  12831412     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether heart rate variability metrics provide an accurate method of monitoring depth of anesthesia, assessing the response to painful stimuli, and assessing neuroautonomic regulation of cardiac activity in children receiving propofol anesthesia for short-duration procedures. DESIGN: Prospective, case series. SETTING: Sixteen-bed pediatric intensive care unit, oncology unit, and endoscopy suite in a tertiary care children's hospital and ophthalmology examination rooms in an associated eye institute. PATIENTS: Thirty-three pediatric patients undergoing propofol anesthesia for short procedures. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Heart rate variability metrics studied included mean, SD, low- and high-frequency power, detrended fluctuation analysis (represented by correlation coefficient, alpha), and approximate entropy. Compared with the initial anesthetized state, we found increased heart rate SD (3.17 +/- 1.31 vs. 7.05 +/- 0.26 bpm, p <.0001), heart rate low-frequency power (3.69 +/- 0.36 vs. 4.48 +/- 0.41 bpm(2)/Hz, p <.0001), heart rate low-/high-frequency ratio (1.47 +/- 0.26 vs. 1.26 +/- 0.24, p =.001), and heart rate alpha (1.12 +/- 0.24 vs. 1.35 +/- 0.21, p <.0001) during painful procedure. Mean heart rate (105.8 +/- 13.4 vs. 101.5 +/- 12.4 bpm, p =.005) and heart rate approximate entropy decreased with painful procedure (0.75 +/- 0.19 vs. 0.53 + 0.16, p <.001), whereas there was no significant change in heart rate high-frequency power (3.04 +/- 0.63 vs. 3.16 +/- 0.71 bpm(2)/Hz, p =.26). CONCLUSIONS: We conclude that power spectral analysis of heart rate variability may be an accurate and clinically useful measure of depth of propofol anesthesia. We speculate that high-frequency heart rate power during propofol anesthesia correlates with depth of anesthesia, whereas low-frequency power allows for assessment of the patient's sympathetic response to pain.
Daniel L Toweill; W Daniel Kovarik; Richard Carr; Danny Kaplan; Susanna Lai; Susan Bratton; Brahm Goldstein
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  4     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-30     Completed Date:  2003-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  308-14     Citation Subset:  IM    
Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health Sciences University, Portland, OR, USA.
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MeSH Terms
Age Factors
Anesthetics, Intravenous / pharmacology*
Child, Preschool
Data Interpretation, Statistical
Heart Rate* / drug effects,  physiology
Monitoring, Intraoperative
Multivariate Analysis
Propofol / pharmacology*
Prospective Studies
Surgical Procedures, Operative*
Time Factors
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol

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

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