Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients
BackgroundHypotension 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.MethodsForty-one patients undergoing spinal anesthesia were inclu...
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doaj-09a02032f5294ba084756003b45bdfd42020-11-25T01:43:13ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632013-10-0165431732110.4097/kjae.2013.65.4.3177668Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patientsTae Dong Kweon0So Yeon Kim1Sung Ah Cho2Ji Hoon Kim3Young Ran Kang4Yang-Sik Shin5Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.BackgroundHypotension 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.MethodsForty-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).ResultsModerate 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.ConclusionsHeart rate variability is not a reliable predictor of hypotension after spinal block in hypertensive patients whose sympathetic activity is already depressed.http://ekja.org/upload/pdf/kjae-65-317.pdfhypertensionhypotensionparasympathetic nervous systemspinal anesthesiasympathetic nervous system |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tae Dong Kweon So Yeon Kim Sung Ah Cho Ji Hoon Kim Young Ran Kang Yang-Sik Shin |
spellingShingle |
Tae Dong Kweon So Yeon Kim Sung Ah Cho Ji Hoon Kim Young Ran Kang Yang-Sik Shin Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients Korean Journal of Anesthesiology hypertension hypotension parasympathetic nervous system spinal anesthesia sympathetic nervous system |
author_facet |
Tae Dong Kweon So Yeon Kim Sung Ah Cho Ji Hoon Kim Young Ran Kang Yang-Sik Shin |
author_sort |
Tae Dong Kweon |
title |
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
title_short |
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
title_full |
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
title_fullStr |
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
title_full_unstemmed |
Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
title_sort |
heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients |
publisher |
Korean Society of Anesthesiologists |
series |
Korean Journal of Anesthesiology |
issn |
2005-6419 2005-7563 |
publishDate |
2013-10-01 |
description |
BackgroundHypotension 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.MethodsForty-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).ResultsModerate 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.ConclusionsHeart rate variability is not a reliable predictor of hypotension after spinal block in hypertensive patients whose sympathetic activity is already depressed. |
topic |
hypertension hypotension parasympathetic nervous system spinal anesthesia sympathetic nervous system |
url |
http://ekja.org/upload/pdf/kjae-65-317.pdf |
work_keys_str_mv |
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