|
KMID : 0356920130650040317
|
|
Korean Journal of Anesthesiology
2013 Volume.65 No. 4 p.317 ~ p.321
|
|
|
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients
|
|
Kweon Tae-Dong
Kim So-Yeon
Shin Yang-Sik
Cho Sung-Ah
Kim Ji-Hoon
Kang Young-Ran
|
|
|
Abstract
|
|
|
Background: Hypotension is a common phenomenon after spinal anesthesia in hypertensive patients. We investigated whether heart rate variability could predict the occurrence of hypotension after spinal anesthesia in hypertensive patients.
Methods: Forty-one patients undergoing spinal anesthesia were included. Heart rate variability was measured at five different time points such as before fluid loading (baseline), after fluid loading as well as 5 min, 15 min and 30 min after spinal anesthesia. Fluid loading was performed using 5 ml/kg of a crystalloid solution. Baseline total power and low to high frequency ratio (LF/HF) in predicting hypotension after spinal anesthesia were analyzed by calculating the area under the receiver operating characteristic curves (AUC).
Results: Moderate hypotension, defined as a decrease of mean arterial pressure to below 20-30% of the baseline, occurred in 13 patients and severe hypotension, defined as a decrease of mean arterial pressure greater than 30% below the baseline, occurred in 7 patients. LF/HF ratiosand total powers did not significantly change after spinal anesthesia. AUCs of LF/HF ratio for predicting moderate hypotension was 0.685 (P = 0.074), severe hypotension was 0.579 (P = 0.560) and moderate or severe hypotension was 0.652 (P = 0.101), respectively. AUCs of total power for predicting moderate hypotension was 0.571 (P = 0.490), severe hypotension was 0.672 (P = 0.351) and moderate or severe hypotension was 0.509 (P = 0.924), respectively.
Conclusions: Heart rate variability is not a reliable predictor of hypotension after spinal block in hypertensive patients whose sympathetic activity is already depressed.
|
|
|
KEYWORD
|
|
|
Hypertension, Hypotension, Parasympathetic nervous system, Spinal anesthesia, Sympathetic nervous system
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
   
|
|