麻醉劑sevoflurane propofol在手術期間會降低HRV

The effects of surgical levels of sevoflurane and propofol anaesthesia on heart rate variability.

 

Eur J Anaesthesiol.  2007; 24(7):626-33 (ISSN: 0265-0215)

Mäenpää M; Penttilä J; Laitio T; Kaisti K; Kuusela T; Hinkka S; Scheinin H
Turku University Hospital, Department of Surgery, Turku, Finland. mika.eero.maenpaa@utu.fi

BACKGROUND AND OBJECTIVE: We compared heart rate dynamics during surgical levels of propofol and sevoflurane anaesthesia in a highly standardized setting. METHODS: We recorded electrocardiography from 24 anaesthetized healthy male subjects. In the first parallel part of the study, the subjects were anaesthetized either with sevoflurane (n = 8) or propofol (n = 8) targeted to match 1.0, 1.5 and 2.0 minimal alveolar concentration/effective concentration 50. In the second part, a separate group (n = 8) underwent four different anaesthetic regimens targeted to bispectral index 40: sevoflurane alone, sevoflurane + 70% nitrous oxide, propofol alone and propofol + 70% nitrous oxide. The electrocardiography data were analysed using conventional time and frequency domain methods, and the approximate entropy method, which estimates the complexity of the data. RESULTS: The induction of anaesthesia was followed by an overall reduction of heart rate variability, evident in all frequency bands in the spectral analysis, and also in the time domain measures. Approximate entropy decreased at 1 effective concentration 50 with propofol and at 2 minimal alveolar concentration with sevoflurane. In the second part of the study, the time domain variables and high-frequency spectral power were all similarly reduced by sevoflurane and propofol anaesthesia, with and without nitrous oxide. Approximate entropy tended to decrease during propofol anaesthesia. CONCLUSIONS: Hypnotic levels of sevoflurane and propofol anaesthesia suppressed the heart rate variability measured using conventional analysis methods. Deeper surgical levels of anaesthesia also reduce the complexity of heart rate variability.