Autonomic Imbalance of the Heart during Total Spinal Anesthesia Evaluated by Spectral Analysis of Heart Rate Variability

Kimura, Tetsunori; Komatsu, Toru; Hirabayashi, Akiko; Sakuma, I; Shimada, Yasuhiro

doi:10.1097/00000542-199403000-00032

Cited by 22 publications

(8 citation statements)

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“…The results of our study are different from the results of the study done by Hanss R et al, [8], [9] Chamchad D et al, [10], Kimura T et al, [11], Y. Fujiwara S et al, [12] and Fawzy G et al, [13] al. Retrospectively analysed HRV of patients scheduled to undergo elective cesarean delivery during SAB showed significant differences depending on the severity of hypotension after SAB.…”

Section: Discussioncontrasting

confidence: 99%

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Shehata¹,

Sakka

Omran

et al. 2019

Open Access Maced J Med Sci

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AIM: In this study we aimed to find out the heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anesthesia in preeclamptic parturients undergoing elective cesarean section. METHODS: Electrical Cardiometry system was used to measure Heart rate variability (HRV) at five different time points before fluid loading (T0, baseline), after fluid loading (T1), 5 min after spinal anaesthesia (T2), 15 min after spinal anaesthesia (T3) and 30 min after spinal anaesthesia (T4). Traditional HRV measurement was determined using time-domain analysis. This Observational descriptive cohort study was conducted in Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University from February 2018 till June 2019, after approval of the Ethical Committee and written patients consent. RESULTS: The main finding of the current study is that heart rate variability measuring using electrical cardiometry is not reliable as a predictor for hypotension following spinal anaesthesia in preeclamptic parturients undergoing elective cesarean section. CONCLUSION: Heart rate variability cannot be used as a predictor for hypotension following spinal anaesthesia in preeclamptic patients undergoing elective caesarean section using electrical cardiometry.

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Section: Discussioncontrasting

confidence: 99%

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Shehata¹,

Sakka

Omran

et al. 2019

Open Access Maced J Med Sci

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“…Power spectrum densities were calculated for total power, low frequencies (LF: 0.04-0.15 Hz), and high frequencies (HF: 0.15-0.4 Hz) in normalized units. LF reflects sympathetic and parasympathetic control and HF reflects parasympathetic control [14]. The ratio of absolute values of LF and HF (LF/HF) has been reported to correlate with sympathovagal balance [15].…”

Section: Methodsmentioning

confidence: 99%

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

Kweon

Kim

Cho

et al. 2013

Korean J Anesthesiol

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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.

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“…38 They used a variable called the low-frequency/high-frequency (LF/HF) ratio, thought to reflect sympathetic versus parasympathetic balance. 39 This is supported by work performed in the obstetric patient which showed decreasing LF/HF values in patients undergoing a spinal block, and therefore a presumed lower sympathetic outflow. 40 They demonstrated that patients with a higher balance, and thus higher sympathetic tone, were particularly susceptible to spinal hypotension.…”

Section: Assessment Of Autonomic Functionmentioning

confidence: 77%

Predicting spinal hypotension during Caesarean section

Bishop

2014

Southern African Journal of Anaesthesia and Analgesia

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Hypotension under spinal anaesthesia for Caesarean section remains a common problem, with attendant maternal and foetal morbidity. This review examines some of the issues surrounding the prediction of spinal hypotension, including concerns about current evidence, the debate on the mechanism of hypotension and the utility of prediction in this group of patients. It then covers some of the more conventional and established preoperative predictors of hypotension. Particular attention is paid to the assessment of autonomic function and some of the novel methods being used as predictors of severe maternal hypotension. The implications of autonomic dysfunction and areas for future research are discussed.

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Autonomic Imbalance of the Heart during Total Spinal Anesthesia Evaluated by Spectral Analysis of Heart Rate Variability

Cited by 22 publications

References 0 publications

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

Heart Rate Variability as A Predictor of Hypotension Following Spinal Anesthesia for Elective Caesarian Section in Preeclamptic Parturients: A Descriptive Observational Study

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

Predicting spinal hypotension during Caesarean section

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