| Pre-operative measurement of heart rate variability predicts hypotension during general anesthesia. | |
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MedLine Citation:
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PMID: 16643221 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Peri-operative hymodynamic instability is one of the major concerns for anesthesiologists when performing general anesthesia for individuals with autonomic dysfunction. The purpose of this study was to examine the potential usage of pre-operative measurement of heart rate variability (HRV) in identifying which individuals, with or without diabetes, may be at risk of blood pressure (BP) instability during general anesthesia. METHODS: We studied 46 patients with diabetes and 87 patients without diabetes ASA class II or III undergoing elective surgery. Participants' cardiovascular autonomic function and HRV were assessed pre-operatively, and hymodynamic parameters were monitored continuously intra-operatively by an independent observer. RESULTS: Only 6% of the participants were classified as having cardiovascular autonomic neuropathy (CAN) based on traditional autonomic function tests whereas 15% experienced hypotension. Total power (TP, P = 0.006), low frequency (LF, P = 0.012) and high frequency (HF, P = 0.028) were significantly lower in individuals who experienced hypotension compared with those who did not. Multivariate logistic regression analysis revealed that TP [odds ratio (OR) = 0.15, 95% confidence interval (CI) = 0.05-0.47, P = 0.001] independently predicted the incidence of hypotension, indicating that each log ms2 increase in total HRV lowers the incidence of hypotension during general anesthesia by 0.15 times. After stepwise multiple linear regression analysis (R2= 11.5%), HF (beta = -11.1, SE = 2.79, P < 0.001) was the only independent determinant of the magnitude of systolic blood pressure (SBP) reduction at the 15th min after tracheal intubation. CONCLUSIONS: Spectral analysis of HRV is a sensitive method for detecting individuals who may be at risk of BP instability during general anesthesia but may not have apparent CAN according to traditional tests of autonomic function. |
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Authors:
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C-J Huang; C-H Kuok; T B J Kuo; Y-W Hsu; P-S Tsai |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 50 ISSN: 0001-5172 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-28 Completed Date: 2006-11-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 542-8 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aging / physiology Anesthesia, General / adverse effects* Arrhythmias, Cardiac / chemically induced, physiopathology Autonomic Nervous System / drug effects Blood Pressure / drug effects, physiology Electrocardiography Female Heart Rate / physiology* Hemodynamics / drug effects Humans Hypotension / chemically induced* Logistic Models Male Middle Aged Odds Ratio Predictive Value of Tests Sex Characteristics Valsalva Maneuver |
| Comments/Corrections | |
Comment In:
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Acta Anaesthesiol Scand. 2006 Oct;50(9):1170; author reply 1171
[PMID:
16987353
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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