Different effects on circulatory control during volatile induction and maintenance of anesthesia and total intravenous anesthesia: autonomic nervous activity and arterial cardiac baroreflex function evaluated by blood pressure and heart rate variability analysis

Ogawa, Yutaka; Iwasaki, Katsurô; Shibata, Shigeki; Kato, Jitsu; Ogawa, Setsuro; Oi, Yoshiyuki

doi:10.1016/j.jclinane.2005.06.004

Cited by 50 publications

(38 citation statements)

References 34 publications

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“…Sevoflurane is reported to decrease both HF and LF [6,8,9]. These results are consistent with our present study.…”

Section: Discussionsupporting

confidence: 94%

Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Nishiyama

2016

Anaesthesiol Intensive Ther

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Background: The purpose of this study was to compare cardiac sympathetic and parasympathetic balance using heart rate variability (HRV) during induction of anaesthesia between sevoflurane and isoflurane in combination with nitrous oxide. Methods: 40 individuals aged from 30 to 60 years, scheduled for general anaesthesia were equally divided into sevoflurane or isoflurane groups. After 100% oxygen inhalation for a few minutes, anaesthesia was induced with nitrous oxide 3 L min -1 , oxygen 3 L min -1 and sevoflurane or isoflurane. Sevoflurane or isoflurane concentration was increased by 0.5% every 2 to 3 breaths until 5% was attained for sevoflurane, or 3% for isoflurane. Vecuronium was administered to facilitate tracheal intubation. After intubation, sevoflurane was set to 2% while isoflurane was set to 1% with nitrous oxide with oxygen (1:1) for 5 min. Results: Both sevoflurane and isoflurane provoked a decrease in blood pressure, total power, the low frequency component (LF), and high frequency component (HF) of HRV. Although the heart rate increased during isoflurane anaesthesia, it decreased under sevoflurane. The power of LF and HF also decreased in both groups. LF was higher in the isoflurane group while HF was higher in the sevoflurane group. The LF/HF ratio increased transiently in the isoflurane group, but decreased in the sevoflurane group. Conclusion: Anaesthesia induction with isoflurane-nitrous oxide transiently increased cardiac sympathetic activity, while sevoflurane-nitrous oxide decreased both cardiac sympathetic and parasympathetic activities. The balance of cardiac parasympathetic/sympathetic activity was higher in sevoflurane anaesthesia.

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“…Sevoflurane is reported to decrease both HF and LF [6,8,9]. These results are consistent with our present study.…”

Section: Discussionsupporting

confidence: 94%

Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Nishiyama

2016

Anaesthesiol Intensive Ther

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“…Within a multimodal framework including EEG, cardiovascular and respiratory assessment, we have devised a point process framework able to successfully characterize the variations in heartbeat dynamics when applied to PROP and DMED administration protocols. Previous results from our groups and other authors have stressed the importance of dynamic autonomic monitoring during anesthesia, and particularly during PROP and DMED [13,15,19,20,34,44,[46][47][48]51,53,54,72,73,75]. In this presentation, we provide further evidence that our refined methods for analyzing the heartbeat dynamics during administration of specific anesthetic drugs are able to overcome nonstationary limitations, thus providing new real-time monitoring approaches to patients receiving anesthesia.…”

Section: Discussionsupporting

confidence: 52%

“…A recent review article by Mazzeo and colleagues [34] summarizes some of the most relevant findings and limits of HRV as a diagnostic and prognostic tool in anesthesia and concludes that 'investigation of HRV as a method of monitoring the depth of anesthesia, assessing the response to painful stimuli, did not yield uniform results and needs more extensive investigations.' Several other important studies have considered HRV to quantify anesthesia [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51], demonstrating the usefulness of HRV measures. In particular, time-varying identification methods have provided successful characterization of PROP and DMED effects on the ANS [19,20,24,28,44,51].…”

mentioning

confidence: 99%

Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

et al. 2014

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Anesthesia-induced altered arousal depends on drugs having their effect in specific brain regions. These effects are also reflected in autonomic nervous system (ANS) outflow dynamics. To this extent, instantaneous monitoring of ANS outflow, based on neurophysiological and computational modeling, may provide a more accurate assessment of the action of anesthetic agents on the cardiovascular system. This will aid anesthesia care providers in maintaining homeostatic equilibrium and help to minimize drug administration while maintaining antinociceptive effects. In previous studies, we established a point process paradigm for analyzing heartbeat dynamics and have successfully applied these methods to a wide range of cardiovascular data and protocols. We recently devised a novel instantaneous nonlinear assessment of ANS outflow, also suitable and effective for real-time monitoring of the fast hemodynamic and autonomic effects during induction and emergence from anesthesia.Our goal is to demonstrate that our framework is suitable for instantaneous monitoring of the ANS response during administration of a broad range of anesthetic drugs. Specifically, we compare the hemodynamic and autonomic effects in study participants undergoing propofol (PROP) and dexmedetomidine (DMED) administration. Our methods provide an instantaneous characterization of autonomic state at different stages of sedation and anesthesia by tracking autonomic dynamics at very high time-resolution. Our results suggest that refined methods for analyzing linear and nonlinear heartbeat dynamics during administration of specific anesthetic drugs are able to overcome nonstationary limitations as well as reducing inter-subject variability, thus providing a potential real-time monitoring approach for patients receiving anesthesia.

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“…[22] Furthermore, a decrease in blood pressure variability has been reported with volatile induced and maintenance anesthesia that has not been reported with total intravenous anesthesia. [23] Although the postoperative inotropic needs and morbidity rates were similar in our study, the use of DEX effectively attenuated the systolic blood pressure variability and also achieved more stable hemodynamics throughout the operation. In addition, while postoperative mortality and morbidity were similar in both groups, more stable hemodynamics may provide lower cardiac and systemic complications in patients with limited cardiac reserve.…”

Section: Discussionmentioning

confidence: 47%

Dexmedetomidine combined with narcotic anesthesia induction in coronary artery bypass graft surgery

Gümüş¹

2013

Turk Gogus Kalp Dama

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Different effects on circulatory control during volatile induction and maintenance of anesthesia and total intravenous anesthesia: autonomic nervous activity and arterial cardiac baroreflex function evaluated by blood pressure and heart rate variability analysis

Cited by 50 publications

References 34 publications

Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

Dexmedetomidine combined with narcotic anesthesia induction in coronary artery bypass graft surgery

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