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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Linear and nonlinear analysis of heart rate variability during propofol anesthesia for short-duration procedures in children.
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Linear and nonlinear analysis of heart rate variability during propofol anesthesia for short-duration procedures in children.

机译：儿童短期异丙酚麻醉期间心率变异性的线性和非线性分析。

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OBJECTIVE: To determine whether heart rate variability metrics provide an accurate method of monitoring depth of anesthesia, assessing the response to painful stimuli, and assessing neuroautonomic regulation of cardiac activity in children receiving propofol anesthesia for short-duration procedures. DESIGN: Prospective, case series. SETTING: Sixteen-bed pediatric intensive care unit, oncology unit, and endoscopy suite in a tertiary care children's hospital and ophthalmology examination rooms in an associated eye institute. PATIENTS: Thirty-three pediatric patients undergoing propofol anesthesia for short procedures. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Heart rate variability metrics studied included mean, SD, low- and high-frequency power, detrended fluctuation analysis (represented by correlation coefficient, alpha), and approximate entropy. Compared with the initial anesthetized state, we found increased heart rate SD (3.17 +/- 1.31 vs. 7.05 +/- 0.26 bpm, p <.0001), heart rate low-frequency power (3.69 +/- 0.36 vs. 4.48 +/- 0.41 bpm(2)/Hz, p <.0001), heart rate low-/high-frequency ratio (1.47 +/- 0.26 vs. 1.26 +/- 0.24, p =.001), and heart rate alpha (1.12 +/- 0.24 vs. 1.35 +/- 0.21, p <.0001) during painful procedure. Mean heart rate (105.8 +/- 13.4 vs. 101.5 +/- 12.4 bpm, p =.005) and heart rate approximate entropy decreased with painful procedure (0.75 +/- 0.19 vs. 0.53 + 0.16, p <.001), whereas there was no significant change in heart rate high-frequency power (3.04 +/- 0.63 vs. 3.16 +/- 0.71 bpm(2)/Hz, p =.26). CONCLUSIONS: We conclude that power spectral analysis of heart rate variability may be an accurate and clinically useful measure of depth of propofol anesthesia. We speculate that high-frequency heart rate power during propofol anesthesia correlates with depth of anesthesia, whereas low-frequency power allows for assessment of the patient's sympathetic response to pain.
机译：目的：确定心律变异性指标是否为监测麻醉深度，短期接受丙泊酚麻醉的儿童的心脏活动的神经自主调节，提供监测麻醉深度，评估对疼痛刺激的反应的准确方法。设计：前瞻性案例系列。地点：三级医疗儿童医院的16张病床重症监护病房，肿瘤科和内窥镜检查室以及相关眼科研究所的眼科检查室。患者：33例接受小剂量异丙酚麻醉的儿科患者。干预措施：无。测量和主要结果：研究的心率变异性指标包括均值，SD，低频和高频功率，去趋势波动分析（由相关系数α表示）和近似熵。与初始麻醉状态相比，我们发现心率SD升高（3.17 +/- 1.31比7.05 +/- 0.26 bpm，p <.0001），心率低频能量（3.69 +/- 0.36 vs. 4.48 + /-0.41 bpm（2）/ Hz，p <.0001），心率低频/高频比率（1.47 +/- 0.26与1.26 +/- 0.24，p = .001）和心率alpha（疼痛过程中的1.12 +/- 0.24与1.35 +/- 0.21，p <.0001）。平均心率（105.8 +/- 13.4 vs.101.5 +/- 12.4 bpm，p = .005）和心率近似熵随着痛苦手术而降低（0.75 +/- 0.19 vs. 0.53 + 0.16，p <.001），而心率高频功率无明显变化（3.04 +/- 0.63 vs. 3.16 +/- 0.71 bpm（2）/ Hz，p = .26）。结论：我们得出结论，心率变异性的功率谱分析可能是丙泊酚麻醉深度的准确和临床有用的度量。我们推测，异丙酚麻醉期间的高频心率功率与麻醉深度相关，而低频功率可以评估患者对疼痛的共鸣反应。

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