Key result
Preoperative HRV parameters associate with spinal anesthesia hypotension but show poor predictive accuracy.
Why the study?
Pre-existing autonomic dysfunction in diabetes mellitus increases the risk of hypotension after spinal anaesthesia, but preoperative clinical tests cannot effectively predict it.
Can preoperative measurement of heart rate variability predict hypotension after spinal anaesthesia in patients with diabetes mellitus?
Observational (n=120)
No
Can preoperative measurement of heart rate variability predict hypotension after spinal anaesthesia in patients with diabetes mellitus?
While reduced heart rate variability is associated with post-spinal anaesthesia hypotension in diabetic patients, its low predictive accuracy limits its utility as a standalone screening tool.
Answers are grounded in this paper and cite their sources.
Preoperative heart rate variability lacks sufficient accuracy for standalone screening of post-spinal hypotension; leaves open.
Hypotension is one of the most common side effects after spinal anaesthesia (SA), particularly in patients with diabetes mellitus (DM). The risk of spinal hypotension is increased due to the pre-existing autonomic dysfunction (AD) and can lead to significant morbidity and mortality.[1] Though there are various preoperative clinical tests to assess AD, none can effectively predict post-spinal hypotension.[2] The aim of this study was to assess whether preoperative measurement of heart rate variability (HRV) can predict hypotension after SA in patients with DM.
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Panta et al. (2019) conducted an observational in Type 2 diabetes mellitus undergoing elective surgeries under spinal anaesthesia (n=120). Preoperative heart rate variability (HRV) parameters (SDNN, RMSSD) was evaluated on Hypotension after spinal anaesthesia (>20% fall in mean arterial pressure from baseline). Preoperative heart rate variability parameters SDNN and RMSSD were independently associated with hypotension after spinal anaesthesia but demonstrated poor predictive accuracy (AUC 0.651 and 0.683, respectively).
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