The influence of low epidural anesthesia on HRV and blood pressure,heart rate in elderly hypertensive patients / 中国基层医药

Objective To observe the influence of low epidural anesthesia on heart rate variability (HRV) and blood pressure,heart rate in elderly hypertensive patients.Methods 125 patients who were adopted routine selective pelvic cavity operation or lower limb operation were divided into the two groups,the observation group(56 cases) complicate with hypertension,control group (69 cases)with normal blood pressure.The heart rate,blood pressure and low frequency,high frequency of HRV before and 5min,15min,45min after anesthesia were monitored and compared.Results Before operation and 5,15,45 min after anesthesia,the systolic blood pressure were (150.2 ±12.4)mmHg,(142.6 ±12.9)mmHg,(127.6 ±12.9)mmHg,(123.7 ±11.3)mmHg,diastolic blood pressure were(84.2 ±12.3)mmHg,(75.3 ±10.4)mmHg,(73.7 ±8.61)mmHg,(71.7 ±7.3)mmHg,heart rates were (88.4 ±11.3)times/min,(82.3 ±9.1)times/min,(78.4 ±10.5)times/min,(77.5 ±10.5)times/min,low frequency ofHRV were (87.5 ±23.7)Hz,(76.4 ±22.2)Hz,(55.4 ±22.1)Hz,(62.4 ±21.3)Hz,high frequency of HRV were(50.2 ±22.2)Hz,(32.3 ±16.7)Hz,(29.5 ±18.3)Hz,(26.3 ±18.4)Hz in the observation group;The systolicblood pressure were (133.6 ±11.4)mmHg,(123.1 ±9.5)mmHg,(121.6 ±10.1)mmHg,(120.3 ±16.3)mmHg,diastolic blood pressure were (77.3 ±11.8)mmHg,(71.4 ±10.5)mmHg,(70.4 ±10.2)mmHg,(71.2 ±8.6)mmHg,heart rate were (85.8 ±10.7 )times/min,(85.8 ±10.7 )times/min,(84.3 ±11.4)times/min,(84.5 ±11.9)times/min,low frequency of HRV were (69.1 ±20.7)Hz,(59.6 ±22.1)Hz,(45.7 ±26.8)Hz,(56.3 ±17.4)Hz,high frequency of HRV were (39.5 ±20.3)Hz,(34.6 ±18.9)Hz,(40.6 ±21.7)Hz,(41.1 ±18.1)Hzin the control group;The systolic blood pressure and diastolic blood pressure in the observation group after anesthesiawere lower than those before operation(systolic blood pressure:t =4.622,5.361,5.732,all P <0.05;diastolic bloodpressure:t =4.778,5.246,5.835,all P <0.05),The systolic blood pressure and diastolic blood pressure in the control group after anesthesia were lower than those before operation(systolic blood pressure:t =3.135,3.526,3.778,allP <0.05;diastolic blood pressure:t =3.636,3.578,3.467,all P <0.05),The systolic blood pressure and diastolicblood pressure in the observation group declined by a larger margin than those in the control group(t =3.782,3.825,3.562,all P <0.05),the heart rate after anesthesia were lower than those before operation both groups(observationgroup:t =4.613,5.724,6.146,all P <0.05;control group:t =3.143,3.672,3.572,all P <0.05),the heart rate inthe observation group declined by a larger margin than those in the control group(t =3.052,3.462,3.782,all P <0.05),low frequency of HRV and high frequency of HRV in the observation group after anesthesia were lower thanthose before operation(low frequency of HRV:t =4.144,5.156,4.714,all P <0.05;high frequency of HRV:t =4.614,4.352,4.667,all P <0.05),low frequency of HRV and high frequency of HRV in the control group after anesthesia were lower than those before operation(low frequency of HRV:t =2.625,3.622,3.725,all P <0.05;highfrequency of HRV:t =3.273,3.605,3.726,all P <0.05),low frequency of HRV and high frequency of HRV in theobservation group declined by a larger margin than those in the control group(low frequency of HRV:t =3.578,3.061,3.136,all P <0.05;high frequency of HRV:t =3.851,3.414,3.684,all P <0.05).Conclusion Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly hypertensive patients.