Heart rate variability may be more useful than pulse transit time for confirming successful caudal block under general anesthesia in children

Song, In Kyung; Ji, Sang‐Hwan; Kim, Eun‐Hee; Lee, Ji‐Hyun; Kim, Jin‐Tae; Kim, Hee‐Soo

doi:10.17085/apm.2017.12.2.140

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…Another application of HRV monitoring was described by Song et al . [ 42 ]. When performing epidural blockade from sacral access in an unconscious patient, which is often the case in paediatric anaesthesia, it is not easy to confirm the effectiveness of the procedure.…”

Section: Epidural Blockmentioning

confidence: 99%

Heart rate variability in anaesthesiology – narrative review

Wujtewicz¹,

Owczuk²

2023

ait

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In a healthy person, the sinoatrial node generates rhythmic, regular signals that lead to a contraction of the heart muscle. As early as the 18 th century, it was noted that in animals the pulse rate changes with respiration, and in the mid-19 th century, respiratory variability of heart rate was confirmed in humans [1]. Differences in the distance between successive RR waveforms, as recorded on electrocardiography, are a sign of cardiovascular well-being and are referred to as heart rate variability (HRV) (Figure 1).The primary regulator of heart rate variability is the autonomic nervous system. Thanks to autonomic regulation the heart rate increases or decreases (Figure 2).Analysis of HRV thus provides information about the interplay between the sympathetic and parasympathetic parts of the autonomic nervous system (ANS) and the potential disruption of this delicate balance, influenced by various factors [2].Historical milestones in the study of the cardiovascular system and its variation under the influence of respiration were presented by Billman [1]. The first researchers to highlight the clinical aspects of HRV (in the foetus) were Hon and Lee [3]. In the following years, numerous researchers explored this issue and developed tools to assess the ANS, as described in detail by the aforementioned Billman [1]. HRV analysis became clinically important in the late 1980s when heart rate variability was found to be

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Section: Epidural Blockmentioning

confidence: 99%

Heart rate variability in anaesthesiology – narrative review

Wujtewicz¹,

Owczuk²

2023

ait

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“…As previously mentioned, Harju et al [ 26 ] reported that no increase in SPI was observed during surgical incision, and the responsiveness of SPI to noxious stimuli was blunted in children undergoing ultrasound-guided ilioinguinal and iliohypogastric nerve block after anesthesia induction for inguinal hernia surgery, suggesting that SPI monitoring may be useful in discriminating the success of regional analgesia in pediatric patients. Song et al [ 99 ] observed significant changes in some HRV parameters after performing a caudal block in pediatric patients undergoing urological surgery under general anesthesia. They concluded that these HRV changes indicated reduced sympathetic activity and increased heart rate predictability, suggesting that the assessment of the HRV parameters can be an indicator of a successful caudal block.…”

Section: Regional Analgesia and Opioid Consumption During General Anementioning

confidence: 99%

Nociception monitoring tools using autonomic tone changes for intraoperative analgesic guidance in pediatric patients

Lim

2019

Anesth Pain Med

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Nociception monitoring devices using changes in autonomic nervous system activity have been developed in numerous ways. Although there have been few studies conducted on children, compared to the relatively higher number of studies on adults, most of the nociception monitors in children, as in adults, appear to be more useful than the standard clinical practice that uses hemodynamic parameters in the evaluation and treatment of intraoperative nociception (pain) during general anesthesia. Particularly, when monitoring the surgical pleth index (SPI) in anesthetized children, the application of a new target range of SPI values (≤ 40) to the SPI monitoring criteria seems to be necessary for providing a more proper intraoperative analgesia. The analgesia nociception index (ANI) shows promising results in anesthetized adults, and recently, positive results along with cardiorespiratory coherence have been reported in pediatric patients. Newborn infant parasympathetic evaluation (NIPE) could be useful for providing adequate analgesia in newborns, infants, and children under 2 years of age in anesthetized or awake states. In cases of skin conductance and pupillometry, further studies are needed. Understanding the pros, cons, and limitations of these nociception monitoring tools will provide more effective and safe intraoperative analgesia to pediatric patients undergoing general anesthesia, and it may also help to plan and conduct promising research on the use of perioperative nociception monitoring in pediatric patients in the future.

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Heart rate variability may be more useful than pulse transit time for confirming successful caudal block under general anesthesia in children

Cited by 2 publications

References 26 publications

Heart rate variability in anaesthesiology – narrative review

Heart rate variability in anaesthesiology – narrative review

Nociception monitoring tools using autonomic tone changes for intraoperative analgesic guidance in pediatric patients

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