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Link between heart rate and blood pressure Mayer wave during general anesthesia.
MedLine Citation:
PMID:  21318461     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Mayer wave (~10 s) blood pressure (BP) oscillations may represent rhythmic vasomotor activity. However, it remains unclear if volatile anesthetics disturb the coherence between heart rate (HR) and BP rhythms in this region, which may result in improperly affecting BP-HR modulation by the baroreflex, especially when sympathetic stimulation is evoked during general anesthesia using sevoflurane-nitrous oxide (Sev-N(2)O). METHODS: Twenty-seven patients were anesthetized with Sev-N(2)O, followed by surgical incision which induces Mayer wave augmentation. Baseline status before surgical incision was compared with that of 19 awake volunteers, and with status after surgical incision. Baroreflex function was assessed by gain and coherence by transfer function analysis, and the baroreflex effectiveness index (BEI). BP Mayer waves were measured by BP variability at a low frequency (LF) of ~0.1 Hz, and spontaneous baroreflex sensitivity (BRS) was obtained by assessing transfer function gain at LF (BRS(LF)), and the sequence technique (BRS(SEQ)). RESULTS: Sev-N(2)O anesthesia markedly reduced Mayer waves by 93%, BRS(LF) by 42%, BRS(SEQ) by 81%, BEI by 37%, coherence by 42%, and the number of coherent segments by 73%, compared with awake controls. During sympathetic stimulation by surgical incision, however, augmentation of Mayer waves (-1.57 ± 0.72 vs. -0.60 ± 1.00, ln mmHg(2) P < 0.001) did not improve depressed coherence above 0.5 (0.37 ± 0.09 vs. 0.43 ± 0.11) or BEI (0.17 ± 0.13 vs. 0.13 ± 0.05). CONCLUSIONS: Sev-N(2)O anesthesia alters the link between HR and BP Mayer wave oscillation even during sympathetic stimulation, indicating weak spontaneous baroreceptor-HR modulation during general anesthesia.
Authors:
Won-Jung Shin; Su-Jin Kang; Young-Kug Kim; Seung-Hye Seong; Sung-Min Han; Gyu-Sam Hwang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-13
Journal Detail:
Title:  Clinical autonomic research : official journal of the Clinical Autonomic Research Society     Volume:  -     ISSN:  1619-1560     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106549     Medline TA:  Clin Auton Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2dong, Songpa-gu, Seoul, Korea.
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