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November 8, 2010Acta Anaesthesiologica Scandinavica

Heart rate variability may identify patients who will develop severe bradycardia during spinal anaesthesia

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Key result

High-frequency heart rate variability and baseline heart rate predicted severe bradycardia (<45 b.p.m.) during spinal anaesthesia with a sensitivity of 65% and specificity of 74%.

Why the study?

Does preoperative Heart Rate Variability (HRV) assessment predict the development of severe bradycardia during spinal anaesthesia in healthy patients?

Population

80 ASA I-II patients, 21-60 years of age, undergoing elective surgery under spinal anaesthesia

Design

Cohort

Follow-up

during spinal anaesthesia

Authors

ACA. ChatzimichaliAZArgyro ZoumprouliMMMaria Metaxari

Discussion

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Overview

HRV may flag patients at risk for severe bradycardia during spinal anesthesia; leaves open whether risk stratification improves outcomes.

Study Design

Type

Observational (n=80)

Structured PICO

Does preoperative Heart Rate Variability (HRV) assessment predict the development of severe bradycardia during spinal anaesthesia in healthy patients?

P
Population
80 ASA I-II patients, aged 21-60 years, undergoing elective surgery under spinal anaesthesia.
E
Exposure
Preoperative assessment of Heart Rate Variability (HRV) for 25 minutes before spinal block, specifically evaluating high-frequency (HF) component and baseline heart rate
O
Outcome
Development of severe bradycardia (<45 b.p.m.) during spinal anaesthesiasafety

Main Result

Effect estimate: Sensitivity 65%, Specificity 74%

p-value: p=<0.05

Preoperative assessment of high-frequency heart rate variability and baseline heart rate can help identify patients at risk for severe bradycardia during spinal anaesthesia.

Cite This Study

Chatzimichali et al. (2010) conducted an observational in Elective surgery under spinal anaesthesia (n=80). High-frequency (HF) component of Heart Rate Variability (HRV) and baseline heart rate vs. Low HF component / different baseline heart rate was evaluated on Severe bradycardia (<45 b.p.m.) during spinal anaesthesia (Sensitivity 65%, Specificity 74%, p=<0.05). High-frequency heart rate variability and baseline heart rate predicted severe bradycardia (<45 b.p.m.) during spinal anaesthesia with a sensitivity of 65% and specificity of 74%.

synapsesocial.com/papers/6a623f5a437918011ec930dfhttps://doi.org/10.1111/j.1399-6576.2010.02339.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Heart Rate Variability Predicts Severe Hypotension after Spinal Anesthesia for Elective Cesarean Delivery2005 · 147 citations
  2. 2Changes in heart rate variability may reflect sympatholysis during spinal anaesthesia2007 · 36 citations
  3. 3Sympathovagal Effects of Spinal Anesthesia Assessed by Heart Rate Variability Analysis1995 · 74 citations
  4. 4Using Heart Rate Variability to Stratify Risk of Obstetric Patients Undergoing Spinal Anesthesia2004 · 82 citations
  5. 5A greater decrease in blood pressure after spinal anaesthesia in patients with low entropy of the RR interval2007 · 36 citations