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January 1, 2013Korean Journal of AnesthesiologyOpen Access

Heart rate variability as a predictor of hypotension after spinal anesthesia in hypertensive patients

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Why the study?

Does baseline heart rate variability predict hypotension after spinal anesthesia in hypertensive patients?

Population

41 hypertensive patients undergoing spinal blockades for elective surgeries, receiving antihypertensive…

Design

Cohort

Follow-up

30 minutes after spinal anesthesia

Authors

TKTae Dong KweonSKSo Yeon KimSCSung Ah Cho

Discussion

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Overview

HRV parameters should not guide hypotension risk assessment before spinal anesthesia in hypertensives; leaves open identification of reliable preoperative markers.

Structured PICO

Does baseline heart rate variability predict hypotension after spinal anesthesia in hypertensive patients?

P
Population
41 hypertensive patients (mean age 67, 2 male / 39 female) undergoing spinal blockades for elective surgeries, receiving antihypertensive medication for at least six months. Excluded: patients with cardiac arrhythmias, coagulopathies, and spinal surgery histories.
I
Intervention
Heart rate variability (HRV) measurement (baseline total power and low to high frequency ratio [LF/HF]) before spinal anesthesia
O
Outcome
Occurrence of moderate (decrease of mean arterial pressure 20-30% below baseline) or severe (decrease of mean arterial pressure >30% below baseline) hypotension after spinal anesthesiasurrogate

Baseline heart rate variability parameters (LF/HF ratio and total power) are not reliable predictors of hypotension after spinal anesthesia in hypertensive patients whose sympathetic activity is already depressed.

Limitations

  • Broad spinal block level (T10-T1) resulting in diverse degrees of sympathetic blockade
  • Inclusion of many factors affecting HRV (diabetes mellitus, ischemic heart disease, antihypertensive medications, spontaneous respiration)
  • Preoperative anxiety could influence baseline HRV

Cite This Study

Kweon et al. (2013) studied this question.

synapsesocial.com/papers/6a8a53071e528df4f2ec714fhttps://doi.org/10.4097/kjae.2013.65.4.317
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Also Consider

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

  1. 1The Incidence and Risk Factors for Hypotension After Spinal Anesthesia Induction: An Analysis with Automated Data Collection2002 · 167 citations
  2. 2Pre‐operative measurement of heart rate variability predicts hypotension during general anesthesia2006 · 75 citations
  3. 3Changes in heart rate variability may reflect sympatholysis during spinal anaesthesia2007 · 36 citations
  4. 4Does heart rate variability predict hypotension and bradycardia after induction of general anaesthesia in high risk cardiovascular patients?*2008 · 53 citations
  5. 5Incidence and Risk Factors for Side Effects of Spinal Anesthesia1992 · 639 citations