What is the clinical evidence from this study?

Study design: Observational. Population: Elective surgery requiring general anesthesia (n=30). Intervention: Propofol vs. Baseline (30 s prior to administration). Primary outcome: Early changes in the sympathetic and parasympathetic nervous systems and sympathovagal balance (HFi, LFi, LFi/HFi ratio) (p=<0.001).

September 13, 2021Frontiers in PhysiologyOpen Access

Strong Early Phase Parasympathetic Inhibition Followed by Sympathetic Withdrawal During Propofol Induction: Temporal Response Assessed by Wavelet-Based Spectral Analysis and Photoplethysmography

Q: What are the key findings of this study?

Propofol induction caused significant immediate changes in autonomic nervous system activity, characterized by early parasympathetic inhibition followed by sympathetic withdrawal.

View Full Paper

Ask AI

Bookmark

Key result

Propofol induction caused significant immediate changes in autonomic nervous system activity, characterized by early parasympathetic inhibition followed by sympathetic withdrawal.

Why the study?

Induction of anesthesia with propofol disturbs hemodynamics, but its specific impact on autonomic function remains unclear.

Does propofol induction alter cardiac autonomic nervous system activity and peripheral sympathetic outflow in patients undergoing elective surgery?

Comparison

Early and late phases after propofol induction vs baseline

Design

Physiologic observational study

Follow-up

120 s after propofol induction

Authors

HWHsin‐Yi WangNational Central University MLMen‐Tzung LoElectrophysiology KCKun-Hui ChenNational Yang Ming Chiao Tung University

Discussion

Member takes

Implication

Propofol induction may trigger early parasympathetic inhibition then sympathetic withdrawal; leaves open optimal hemodynamic strategies pending larger trials.

Study Design

Type

Observational (n=30)

Blinding

Open-label

Multicenter

Structured PICO

Does propofol induction alter cardiac autonomic nervous system activity and peripheral sympathetic outflow in patients undergoing elective surgery?

Population

30 healthy adults (ASA physical status I-II) undergoing elective surgery with propofol induction, monitored for 2 minutes to assess autonomic nervous system dynamics.

Intervention

Propofol 1.5-2.5 mg/kg IV bolus for induction of anesthesia, pre-treated with lidocaine 0.2 mg/kg.

Comparator

Baseline measurements (30 seconds before administration of propofol).

Outcome

Changes in instantaneous high-frequency (HFi), low-frequency (LFi) bands, LFi/HFi ratio, and pulse photoplethysmography (PPG) amplitude from 30 seconds before to 120 seconds after propofol induction.surrogate

Main Result

p-value: p=<0.001

Propofol induction causes immediate parasympathetic inhibition followed by sympathetic withdrawal, demonstrating rapid temporal changes in autonomic nervous system activity.

Limitations

Propofol-induced changes in respiratory rate and tidal volume may have influenced the HF power of the R-R intervals.
A wavelet-based second-by-second higher time resolution approach would overestimate the relationship with nervous system activity.
Autonomic function was not confirmed by direct measurement.
High-risk patients, including those with diabetes and the elderly, were excluded.
Wavelet-based second-by-second higher time resolution approach would overestimate the relationship with nervous system activity.
Did not confirm the autonomic function by direct measurement.
Excluded high-risk patients, including those with diabetes and the elderly.

Cite This Study

Wang et al. (2021) conducted an observational in Elective surgery requiring general anesthesia (n=30). Propofol vs. Baseline (30 s prior to administration) was evaluated on Early changes in the sympathetic and parasympathetic nervous systems and sympathovagal balance (HFi, LFi, LFi/HFi ratio) (p=<0.001). Propofol induction caused significant immediate changes in autonomic nervous system activity, characterized by early parasympathetic inhibition followed by sympathetic withdrawal.

synapsesocial.com/papers/6a7b68231b9920df6d898532 https://doi.org/10.3389/fphys.2021.705153

View Full Paper

Ask AI

Bookmark

Implication

Propofol induction may trigger early parasympathetic inhibition then sympathetic withdrawal; leaves open optimal hemodynamic strategies pending larger trials.

Strong Early Phase Parasympathetic Inhibition Followed by Sympathetic Withdrawal During Propofol Induction: Temporal Response Assessed by Wavelet-Based Spectral Analysis and Photoplethysmography

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Strong Early Phase Parasympathetic Inhibition Followed by Sympathetic Withdrawal During Propofol Induction: Temporal Response Assessed by Wavelet-Based Spectral Analysis and Photoplethysmography

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider