Heart rate variability may be more useful than pulse transit time for confirming successful caudal block under general anesthesia in children
Anesthesia and Pain Medicine
;
: 140-146, 2017.
Article
in English
| WPRIM
| ID: wpr-28774
ABSTRACT
BACKGROUND:
Confirming a successful caudal block is challenging in the pediatric population. Pulse transit time (PTT) may reflect the decrease in arterial resistance and may act as a potential indicator for confirming successful peripheral nerve or axial block. Heart rate variability (HRV) is also a possible candidate because it may be influenced by variation in sympathetic tone. We expected an increasing PTT pattern and change in HRV parameters after caudal block.METHODS:
We enrolled 27 male patients (range, 1–4 years old) who were scheduled for urological surgeries. Caudal block was performed with 1 ml/kg of 0.25% ropivacaine and 1 200,000 epinephrine under sevoflurane anesthesia after the surgery. Successful block was confirmed by auscultation and ultrasonography. PTT and HRV parameters, such as standard deviation of normal-to-normal intervals, root mean square of successive differences, very low-frequency power, low-frequency power (LF), high-frequency power (HF), LF/HF ratio, approximate entropy (ApEn) were calculated based on electrocardiography from 1 min before to 5 min after the block. Those variables were analyzed by repeated measures analysis of variance.RESULTS:
No significant change was found in PTT with time interval after caudal block. Heart rate and ApEn of the R-R interval decreased with time interval (P = 0.001, 0.033, respectively). Some HRV parameters showed notable changes, although statistically insignificant.CONCLUSIONS:
The PTT pattern may not be an indicator for successful caudal block. However, heart rate with parameters of HRV analysis may be alternatives.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Peripheral Nerves
/
Auscultation
/
Epinephrine
/
Ultrasonography
/
Entropy
/
Electrocardiography
/
Pulse Wave Analysis
/
Heart
/
Heart Rate
/
Anesthesia
Type of study:
Diagnostic study
Limits:
Child
/
Humans
/
Male
Language:
English
Journal:
Anesthesia and Pain Medicine
Year:
2017
Type:
Article
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