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Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients

Authors
 Tae Dong Kweon  ;  So Yeon Kim  ;  Sung Ah Cho  ;  Ji Hoon Kim  ;  Young Ran Kang  ;  Yang-Sik Shin 
Citation
 Korean Journal of Anesthesiology, Vol.65(4) : 317-321, 2013 
Journal Title
 Korean Journal of Anesthesiology 
ISSN
 2005-6419 
Issue Date
2013
Keywords
Hypertension ; Hypotension ; Parasympathetic nervous system ; Spinal anesthesia ; Sympathetic nervous system
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.
Files in This Item:
T201303129.pdf Download
DOI
10.4097/kjae.2013.65.4.317
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kweon, Tae Dong(권태동) ORCID logo https://orcid.org/0000-0002-5451-1856
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Shin, Yang Sik(신양식)
Cho, Sung Ah(조성아)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87824
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