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首页> 外文期刊>Surgical Endoscopy >Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during sevoflurane, isoflurane, or propofol anesthesia.
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Effects of pneumoperitoneum on cardiac autonomic nervous activity evaluated by heart rate variability analysis during sevoflurane, isoflurane, or propofol anesthesia.

机译：在七氟醚，异氟烷或丙泊酚麻醉期间，通过心率变异性分析评估气腹对心脏自主神经活动的影响。

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摘要

BACKGROUND: The effects of pneumoperitoneum on the activity of the cardiac autonomic nervous system have not been completely understood. METHODS: In this study, 45 unpremedicated adult patients who underwent laparoscopic cholecystectomy were anesthetized with either 3.5% sevoflurane, 2% isoflurane, or 8 mg/kg/h propofol (15 patients in each group). The status of cardiac autonomic nervous activity was evaluated by heart rate variability analysis three times: once when the patient was awake, once after induction of general anesthesia, and once after insufflation for pneumoperitoneum. Intra-abdominal pressure was maintained automatically at 10 mm Hg by a carbon dioxide (CO(2)) insufflator. For each measurement, electrocardiogram was recorded for 256 s and played back offline to detect R-R intervals. Power spectral analysis of heart rate variability was applied, and the low-frequency (LF, 0.04-0.15 Hz) and high-frequency (HF, 0.15-0. 40 Hz) bands of the spectral density of the heart rate variability were obtained from a power spectra of R-R intervals using the fast-Fourier transform algorithm. The HF/LF ratio also was analyzed. RESULTS: Measurements of heart rate variability in the three groups showed similar change. Although the power of HF, which represents parasympathetic nervous activity, did not change, the power of LF, which represents both sympathetic and parasympathetic nervous activity, decreased during the anesthetized stage and increased during the insufflated stage. The HF/LF ratio, which represents the balance of parasympathetic and sympathetic activity, increased after induction of general anesthesia, and decreased after insufflation. CONCLUSIONS: Our results suggest that pneumoperitoneum increases sympathetic cardiac activity. The choice of general anesthetic did not seem to have a major influence on the change in the cardiac autonomic nervous system after induction of pneumoperitoneum for laparoscopic cholecystectomy.
机译：背景：气腹对心脏自主神经系统活动的影响尚未完全了解。方法：在这项研究中，对接受腹腔镜胆囊切除术的45例未经药物治疗的成年患者用3.5％的七氟醚，2％的异氟烷​​或8 mg / kg / h的异丙酚麻醉（每组15例）。通过心率变异性分析对心脏自主神经活动的状态进行三次评估：一次是在患者清醒时，一次是在全身麻醉后，一次是在气腹通气后。通过二氧化碳（CO（2））吹入器自动将腹腔内压力维持在10毫米汞柱。对于每次测量，心电图记录256 s，然后离线播放以检测R-R间隔。应用心率变异性的功率谱分析，从心率变异性的频谱密度获得低频（LF，0.04-0.15 Hz）和高频（HF，0.15-0。40 Hz）频带，从使用快速傅立叶变换算法绘制RR间隔的功率谱。还分析了HF / LF比。结果：三组心率变异性的测量显示相似的变化。尽管代表副交感神经活动的HF的力量没有改变，但代表交感神经和副交感神经活动的LF的力量在麻醉阶段降低，在吹入阶段增加。 HF / LF比值代表副交感和交感神经活动的平衡，在全身麻醉诱导后增加，而在吹入后降低。结论：我们的结果表明气腹可增加交感神经活动。腹腔镜胆囊切除术诱导气腹后，全麻的选择似乎对心脏自主神经系统的变化没有重大影响。

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