Journal of the Korean Institute of Electrical and Electronic Material Engineers (한국전기전자재료학회논문지)

The Korean Institute of Electrical and Electronic Material Engineers (한국전기전자재료학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Heart Rate Variability with Pulse Transit Time during General Anesthesia

전신 마취 중 심박동변이도와 맥파전달시간 변화의 비교

  • 백승완 (부산대학교 의학전문대학원 마취통증의학교실) ;
  • 김태균 (부산대학교 의학전문대학원 마취통증의학교실) ;
  • 김재형 (인제대학교 컴퓨터응용과학부) ;
  • 전계록 (부산대학교 의학전문대학원 의공학교실) ;
  • 예수영 (부산대학교 의학전문대학원 BK21 고급의료인력양성사업단)
  • Published : 2008.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

Autonomic nervous system of the anesthetized patients can be influenced by the many kinds of stimulations such as intubation, surgical incision and so on. The changes of the heart rates and blood pressures are surrogates of responses of the autonomic system to the external stimulations. Recently, the power spectral analysis of the heart rate variability (HRV) made it easy to know the fractions and changes of sympathetic and parasympathetic autonomic systems. In this study, the changes of pulse transit time, one of the response of vessels to stimulations, was investigated in relation to the HRV. Ten patients were examined and average age is 22.5 $\pm$ 11.04, average weight is 63 $\pm$ 14.4 kg. The patients were anesthetized only by sevoflurane inhalation. Pulse transit time is determined by calculating the difference of the time between the R peak of ECG and the characteristic point of the plethysmography. Power spectral density (PSD) of the HRV was achieved in the frequency of 0.04-0.15 (LF) and 0.15-0.4 (HF). Compared to preanesthetic period the values of LF and LF/HF ratio of HRV were decreased (p<0.05). HF and PTT was increased in anesthetic state with sevoflurane. Otherwise, after intubation, the HF was decreased and LF, LF/HF ratio and PTT were increased. PSD of the HRV is well-known for the index of the autonomic nervous activity. Not only HRV but PTT analysis also is a useful index reflecting the autonomic responses to various stimulations. And this analysis is useful in bed side monitoring because the calculating method is simple and it takes shorter processing time compared to the HRV analysis.

Keywords

References

  1. Stanski D. R., "Monitoring depth of anesthesia", Indian J. Anaesth, Vol. 46, No. 4, p. 323, 2002
  2. Jacoby L. L., Toth J. P., and Yonelinas A. P., "Separating conscious and unconscious influences of memory : Measuring recollection", J. Exp. Psychol., Vol. 122, p. 139, 1993 https://doi.org/10.1037/0096-3445.122.2.139
  3. Laitio R. M., Kaskinoro K., Sarkela M. O., Kaisti K. K., Salmi E., Maksimow A., Langsjo J. W., Aantaa R., Kangas K., Jaaskelainen S., and Scheinin H., "Bispectral index, entropy, and quantitative electroencephalogram during single-agent xenon anesthesia", Anesthesiology, Vol. 108, No. 1, p. 63, 2008 https://doi.org/10.1097/01.anes.0000296106.52472.a6
  4. Yoki M., Morita Y., Kimura T., Doya M., and Kaneda T., "Effects of trend and term sampling on power spectral analysis of heart rate variability during tracheal intubation", Anesthesiology, Vol. 85, No. 3A, p. A406, 1996
  5. 스넬, 임상신경해부학, 신흥메디사이언스, p. 495, 2005
  6. Ahlstrom, C., A. Johansson, F. Uhlin, T. Lanne, and P. Ask., "Noninvasive investigation of blood pressure changes using the pulse wave transit time : a novel approach in the monitoring of hemodialysis patients", Journal of Artificial Organs, Vol. 8, p. 192, 2005 https://doi.org/10.1007/s10047-005-0301-4
  7. O'Rourke, M., "Arterial stiffness ,systolic blood pressure and logical treatment of arterial hypertension", Hypertension, Vol. 15, p. 339, 1990 https://doi.org/10.1161/01.HYP.15.4.339
  8. Mcveigh, G. E., Bratteli, C. W., Morgan, D. J., Alinder, C. M., Glasser, S. P., Finkelstein, S. M., and Cohn, J. N., "Age-related abnormalities in arterial compliance indentified by pressure pulse contour analysis: aging and arterial compliance", Hypertension, Vol. 33, p. 1392, 1999 https://doi.org/10.1161/01.HYP.33.6.1392
  9. Willum-Hansen T., Staessen J. A., Torp-Pedersen C., Rasmussen S., Thijs L., Ibsen H., "Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population", Circulation, Vol. 113, p. 664, 2006 https://doi.org/10.1161/CIRCULATIONAHA.105.579342
  10. Bader H., "Importance of the gerontology of elastic arteries in the development of essential hypertension", Clin Physiol Biochem, Vol. 1, p. 36, 1983
  11. Safar M. E., Levy B. I., Laurent S., and London G. M., "Hypertension and the arterial system: Clinical and therapeutic aspects", J. Hypertens, Vol. 8, No Suppl. 7, p. S113, 1990
  12. Johnson C. P., Baugh R., Wilson C. A., and Burns J., "Age related changes in the tunica media of the vertebral artery: implications for the assessment of vessels injured by trauma", J Clin Pathol, Vol. 54, p. 139, 2001 https://doi.org/10.1136/jcp.54.2.139
  13. Xu C., Zarins C. K., Pannaraj P. S., Bassiouny H. S., and Glagov S., "Hypercholesterolemia superimposed by experimental hypertension induces differential distribution of collagen and elastin", Arterioscler. Thromb. Vasc. Biol., Vol. 20, p. 2566, 2000 https://doi.org/10.1161/01.ATV.20.12.2566
  14. Foo, J. Y., A. P. Bradley, S. J. Wilson, G. R. Williams, C. Dakin, and D. M. Cooper, "Screening of obstructive and central apnoea/hypopnoea in children using variability: a preliminary study", Acta Paediatrica, Vol. 95, No. 5, p. 561, 2006 https://doi.org/10.1080/08035250500477552
  15. Naschitz, J. E., I. Rosner, N. Shaviv, I. Khorshidi, S. Sundick, H. Isseroff, M. Fields, R. M. Priselac, D. Yeshurun, and E. Sabo, "Assessment of cardiovascular reactivity by fractal and recurrence quantification analysis of heart rate and pulse transit time", Journal of Human Hypertension, Vol. 17, No. 2, p. 111, 2003 https://doi.org/10.1038/sj.jhh.1001517
  16. Nitzan, M., B. Khanokh, and Y. Slovik, "The difference in pulse transit time to the toe and finger measured by photo-plethysmography", Physiol. Meas., Vol. 23, No. 1, p. 85, 2002 https://doi.org/10.1088/0967-3334/23/1/308
  17. Akselrod S., Gordon D., Madwed J. B., Snidman N. C., Shannon D. C., and Cohen R. J., "Hemodynamic regulation: Investigation by spectral analysis", Am. J. Physiol., Vol. 228, p. 775, 1975
  18. Galinier M., Fourcade J., Ley N., Boveda S., Solera M. L., and Masabuau P., "Hyperinsulinism, heart rate variability and circadian variability of arterial pressure in obese hypertensive patients", Arch. Mal. Coeur. Vaiss., Vol. 92, No. 8, p. 1105, 1999