Sevoflurane anesthesia decreases cardiac vagal activity and heart rate variability

Background:Drug combinations can be used for optimum obtundation of the hemodynamic response to tracheal intubation. The objective of this trial was to compare the hemodynamic response to laryngoscopy and tracheal intubation after administration of 2 μg/kg fentanyl bolus or a placebo with 2% end tidal sevoflurane at induction of anesthesia.Materials and Methods:A total of 70 surgical patients of either gender, age 18-45 years were selected for this double blind, randomized, placebo controlled trial, with 35 in each group. All patients received a standardized induction with thiopentone, atracurium, and an end tidal concentration of 1 minimum alveolar concentration (MAC) sevoflurane. Heart rate and noninvasive blood pressure were compared to the baseline post induction and for seven minutes post intubation. Some adverse events were noted.Results:The maximum heart rate response was significantly less in the sevoflurane fentanyl group (15% vs. 22%). Significant difference between groups was observed in the systolic blood pressure at six minutes post intubation. Hemodynamic adverse events recorded were similar.Conclusion:Addition of 2 μg fentanyl bolus to 1 MAC sevoflurane anesthesia at induction attenuated the hemodynamic response to a maximum of 15% above baseline values.

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“…[11] Paisansathan demonstrated that sevoflurane anesthesia decreased cardiac vagal activity and heart rate variability. [12]…”

Section: Discussionmentioning

confidence: 99%

Effect of one minimum alveolar concentration sevoflurane with and without fentanyl on hemodynamic response to laryngoscopy and tracheal intubation

Hoda

Khan

2011

J Anaesthesiol Clin Pharmacol

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“…It is also known that general anesthesia may influence HRV 45, 46. Thus, to maintain comparability, anesthesia was carried out in accord with a standardized protocol, and bispectral index (BIS) monitoring was applied in both groups 47.…”

Section: Discussionmentioning

confidence: 99%

Impact of continuous intraoperative neuromonitoring on autonomic nervous system during thyroid surgery

et al. 2010

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“…Sevoflurane decreased LF, but not HF and LF/HF, except for at the lower bispectral index (BIS) values (BIS 40) where LF/HF decreased in a study by Kanaya et al [10]. Therefore, in deep sevoflurane anaesthesia, as also shown in other studies [6,7], both cardiac sympathetic and parasympathetic activity decreased, although the decrease was larger in parasympathetic activity [7].…”

Section: Discussionmentioning

confidence: 61%

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 anesthesia decreases cardiac vagal activity and heart rate variability

Cited by 11 publications

References 19 publications

Effect of one minimum alveolar concentration sevoflurane with and without fentanyl on hemodynamic response to laryngoscopy and tracheal intubation

Effect of one minimum alveolar concentration sevoflurane with and without fentanyl on hemodynamic response to laryngoscopy and tracheal intubation

Impact of continuous intraoperative neuromonitoring on autonomic nervous system during thyroid surgery

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

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