The Influence of Sevoflurane Anesthesia on Various Kinds of Spontaneous Baroreflex Sensitivities / 대한마취과학회지

ABSTRACT

BACKGROUND: In contrast to classic drug injection method, various types of noninvasive spontaneous baroreflex sensitivity (SBRS) methods have been developed using the computer analysis of the spontaneous fluctuation of heart rate and arterial blood pressure for baroreflex evaluation. In this study, we evaluated the effects of sevoflurane anesthesia on SBRS by comparing various SBRS estimates and their correlations before and after sevoflurane anesthesia. METHODS: Radial arterial pressure and electrocardiography were recorded in 50 patients before and after sevoflurane anesthesia. We derived six SBRS indices from the methods including sequence, alpha-index, transfer function analysis and impulse response function. The sequence method measured an average of baroreflex sequences. The alpha-index used the average of the square roots of the ratios between the RRI and SBP spectral power. The transfer function index used RRI and SBP cross-spectral magnitude for this index. The impulse response function method employed an inverse Fourier transform. RESULTS: All SBRS and accompanying correlations were reduced after sevoflurane anesthesia. Low (44%) and high (4%) frequency transfer function gain and sequence SBRS (4%) failed to be computed out of some patients after sevoflurane anesthesia due to poor coherence and absence of a valid sequence. CONCLUSIONS: Sevoflurane anesthesia caused marked depression of SBRS and weakened their correlations. Therefore, it is necessary to understand the characteristics of each SBRS method for selecting an appropriate method during anesthesia.