Differential effects of propofol and sevoflurane on heart rate variability
Differential effects of propofol and sevoflurane on heart rate variability
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DOI：
10.1097/00000542-200301000-00009
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发表时间：
2003-01-01
期刊：
影响因子：
8.8
通讯作者：
Namiki, A
中科院分区：
文献类型：
--
作者：
Kanaya, N;Hirata, N;Namiki, A
背景资料：据报道，丙泊酚可降低交感神经和副交感神经张力;然而，尚不清楚心率变异性的变化是否与麻醉深度相关。本研究的目的是（1）评价不同深度催眠时心率变异性的变化;（2）比较丙泊酚和七氟醚对心率变异性的影响。用脑电双频指数（BIS）监测催眠深度。使用最大熵方法的心率变异性的频谱分析导致具有两个主要区域的特征功率谱，高频（HF）和低频（U）。血流动力学，熵，LF，BY，LF/BT进行监测时，病人清醒，麻醉induction.Results后：丙泊酚和七氟醚降低血压的BIS依赖性的方式，而心率在研究期间没有显着变化。丙泊酚组熵和HF随BIS值降低而降低。虽然LF在麻醉诱导后下降，丙泊酚引起LF没有进一步下降，尽管在BIS值下降。在七氟烷组中，LF随着BIS值的降低而降低。熵和HF减少麻醉诱导后（BIS在80），但是，没有进一步减少，观察到尽管在BIS value.Conclusions的减少：异丙酚麻醉诱导降低血压，熵，HF在BIS依赖的方式，表明异丙酚降低心脏副交感神经张力依赖于催眠的深度。相反，七氟烷未显示心率、血压、HF和熵的BIS依赖性降低，表明七氟烷对心脏副交感神经张力影响很小或没有影响。
Background: Propofol is reported to reduce both sympathetic and parasympathetic tone; however, it is not clear whether the changes in heart rate variability are associated with depth of anesthesia. The purposes of the present study were (1) to evaluate the changes in heart rate variability at different depths of hypnosis and (2) to compare the effects of propofol on heart rate variability with that of sevoflurane.Methods: Thirty patients were randomly allocated into the propofol or sevoflurane for induction of anesthesia. The depth of hypnosis was monitored by the Bispectral Index (BIS). Spectral analysis of heart rate variability using a maximum-entropy method resulted in a characteristic power spectrum with two main regions, a high frequency (HF) and a low frequency (U). Hemodynamics, entropy, LF, BY, and LF/BT were monitored when the patients were awake and after induction of anesthesia.Results: Both propofol and sevoflurane decreased blood pressure in a BIS-dependent manner, whereas heart rate showed no significant changes during the study period. In the propofol group, entropy and HF decreased with a reduction in the BIS value. Although LF decreased after induction of anesthesia, propofol caused no further decrease in LF in spite of a reduction in the BIS value. In the sevoflurane group, LF decreased with a reduction in the BIS value. Entropy and HF decreased after induction of anesthesia (BIS at 80); however, no further decreases were observed in spite of a reduction in the BIS value.Conclusions: Induction of anesthesia with propofol decreased blood pressure, entropy, and HF in a BIS-dependent manner, indicating that propofol reduces cardiac parasympathetic tone depending on the depth of hypnosis. Conversely, sevoflurane did not show the BIS-dependent decreases in heart rate, blood pressure, HF, and entropy, indicating that sevoflurane has little or no effect on cardiac parasympathetic tone.