Key result
Total venous anesthesia caused significant fluctuations in heart rate variability, with maximal parasympathetic activity during propofol infusion and maximal sympathetic predominance during extubation.
Case Report (n=1)
No
Total venous anesthesia induces significant fluctuations in heart rate variability, with maximal sympathetic influence observed during extubation and awakening.
Alerts to potential autonomic instability at extubation with total venous anesthesia; leaves open whether HRV changes predict outcomes in larger studies.
The aim of the study was to characterize the heart rate variability in a patient with no comorbidities, submitted to buccomaxillofacial surgery under total venous anesthesia using the linear frequency and nonlinear methods in the chaos domain (Poincaré plot). Data collection was performed before, during and after the surgical procedure using a Polar V800 cardiofrequencymeter and subsequently analyzed and filtered using the Kumbios HRV 3.0 software. During propofol infusion, elevations in LF, HF, SD1 and SD2 were observed. The LF/HF ratio showed obvious changes, which were found to be maximal during extubation and submaximal during awakening under greater influence of the sympathetic nervous system. The moment of the incision has parameters similar to those of rest. Final surgery maintenance showed the lowest values of LH/HF and SD1/SD2, with lower LF and SD2 values compared to rest. During the awakening, there was a decrease in SD1 and HF, representing the moment of greatest fragility during the total venous anesthesia, being of fundamental importance future studies about their repercussions.
No takes yet. Share an insight, caveat, or question.
Lima et al. (2018) conducted a case report in Zygoma fracture (n=1). Total venous anesthesia (propofol and remifentanil) vs. Resting state (baseline) was evaluated on Heart rate variability (HRV) parameters (LF, HF, LF/HF, SD1, SD2). Total venous anesthesia caused significant fluctuations in heart rate variability, with maximal parasympathetic activity during propofol infusion and maximal sympathetic predominance during extubation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: