Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 317-321, 2013.
Article
in English
| WPRIM
| ID: wpr-100102
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Parasympathetic Nervous System
/
Sympathetic Nervous System
/
ROC Curve
/
Area Under Curve
/
Arterial Pressure
/
Heart
/
Heart Rate
/
Hypertension
/
Hypotension
/
Isotonic Solutions
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Journal of Anesthesiology
Year:
2013
Type:
Article
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