Monitoring System during Enflurane Anesthesia Using Heart Rate Variability / 대한마취과학회지

ABSTRACT

BACKGROUND:We performed spectral analysis and determined the 1/f noise of heart rate variability during enflurane anaesthesia in order to assess the effect of the activity of the autonomic nervous system. METHODS: Data were acquired from 15 patients (ASA I-II) who received gynecological surgery under general anesthesia using enflurane, nitrous oxide and oxygen. We analyzed the spectral components of heart rate variability (HRV) according to the following five periods 1) before premedication, 2) after induction, 3) during skin incision, 4) during recovery, and 5) after surgery. For each power spectrum the density and frequency components were identified as follows (1) low frequency (LF) component (0.04-0.15 Hz) was associated with parasympathetic and sympathetic tone, and was affected by body temperature, the renin-angiotensin system, baroreceptor and vasomotor sympathetic modulation, (2) high frequency (HF) component (0.15-0.5 Hz) was mediated parasympathetic tone and reflected the mechanical influence of the ventilation. In addition the LF/HF ratio, which reflected cardiac sympathovagal balance was monitored. RESULTS: The LF/HF ratio, which reflects the balance of the autonomic nervous system increased remarkably during skin incision and recovery. Also, the beta index, which is related to body activity decreased during skin incision and recovery. CONCLUSIONS: Increased LF/HF was found to be caused by mechanical stimulation, which reflects autonomic nervous system balance, and the beta index was useful for the assessment of body activity.