A greater decrease in blood pressure after spinal anaesthesia in patients with low entropy of the RR interval
A greater decrease in blood pressure after spinal anaesthesia in patients with low entropy of the RR interval
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DOI：
10.1111/j.1399-6576.2007.01435.x
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发表时间：
2007-10-01
影响因子：
2.1
通讯作者：
Komatsu, T.
中科院分区：
文献类型：
--
作者：
Fujiwara, Y.;Sato, Y.;Komatsu, T.
背景：这项研究的目的是确定用新开发的MemCalc方法估计的术前心率变异性(HRV)是否可以预测腰麻(SA)后的低血压。方法：52名年龄为38-84岁的美国麻醉学家协会(American Society of麻醉师)的患者，计划接受择期经尿道手术。用MemCalc方法计算SA前后心率变异性的非线性指标超短时程熵(Usen)。然后根据术前USEN将患者分为两组(LO组和HI组)。通过腰椎间隙L3-4或L4-5鞘内注射等量布比卡因17.5 mg进行SA。结果：SA可显著降低低频/高频(HRV低频分量与高频分量之比)，但对USEN无明显影响。SA后，HI组SBP下降11.4%(9.9%)，LO组下降17.5%(9.8%)(P<；0.05)。结论：SA可显著降低LF/HF，但对USEN无明显影响。Usen低的患者SA后SBP下降幅度更大。此外，USEN低的患者SA后低血压的发生率较高。
Background: The objective of this study was to determine whether pre-operative heart rate variability (HRV) estimated using the newly developed MemCalc method predicts hypotension after spinal anaesthesia (SA).Methods: Fifty-two patients with American Society of Anesthesiologists physical status I or II, aged 38-84 years, scheduled to undergo elective transurethral surgery were investigated in this study. Ultra short-term entropy (UsEn) as a non-linear index of HRV was estimated before and after SA using the MemCalc method. The patients were then assigned to two groups (Group LO and HI) according to pre-operative UsEn. SA was performed by intrathecal injection of 17.5 mg of isobaric bupivacaine via interlumbar spaces L3-4 or L4-5. After SA, the haemodynamic fluctuations were recorded and compared between the two groups.Results: SA significantly decreased LF/HF (a ratio of the low frequency component of HRV to that of the high frequency component) but did not affect UsEn. The percentage decrease in systolic blood pressure (SBP) after SA was 11.4 (9.9)% in group HI, whereas it was 17.5 (9.8)% in group LO (P < 0.05). Furthermore, the number of patients who developed hypotension was significantly higher in group LO.Conclusions: SA significantly decreased LF/HF without affecting UsEn. Patients with a low UsEn developed a greater decrease in SBP after SA. Furthermore, the incidence of hypotension after SA was higher in patients with a low UsEn.