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Canadian Journal of Anaesthesia

, Volume 41, Issue 8, pp 680–687 | Cite as

Power spectral analysis of heart rate and blood pressure variability in lumbar epidural anaesthesia

  • Masayuki Arakawa
  • Fumio Goto
Reports of Investigation
Accepted:

Abstract

The purpose of this study was to evaluate autonomic nervous system activity during high and low lumbar epidural anaesthesia. Ten patients undergoing lower limb surgery with lumbar epidural anaesthesia (low epidural anaesthesia group; mean upper dermal block level, T10.7± 1.1), and ten patients undergoing either abdominal total hysterectomy or ingunial hernia under lumbar epidural anaestehsia (high epidural anaesthesia group; mean upper dermal block level, T5.1± 1.0). Ten healthy volunteers were used as the control group. The autonomic nervous system activity was measured by heart rate and blood pressure variability with power spectral analysis. For the analysis of heart rate variability, frequency components were divided into two factors, a low frequency component RR (LFCrr: 0.03 Hz–0.15 Hz) that mediated sympathetic and parasympathetic activity and a high frequency component RR (HFCRR: 0.15 Hz–0.4 Hz) that mediated parasympathetic activity. In the analysis of blood pressure variability, the frequency components were also divided into two factors; a low frequency component of systolic blood pressure and diastolic blood pressure (LFCsbp and LFCdbp: 0.03 Hz–0.15 Hz) that was mediated by peripheral sympathetic vasomotor activity and a higher frequency component of systolic blood pressure and diastolic blood pressure (HFCSBP and HFCdbp: 0.15 Hz–0.4 Hz) that was mediated by a mechanical consequence of respiration. There were no changes in heart rate variability during epidural anaesthesia. However, LFCsbp and LFCdbp decreased in high epidural anaesthesia (P < 0.01). On the contrary, LFCsbp increased in low epidural anaesthesia (P < 0.01). We conclude that peripheral sympathetic vasomotor activity was activated in low epidural anaesthesia and suppressed in high epidural anaesthesia.

Key words

anaesthetic techniques: epidural monitoring: blood pressure, ECG 

Résumé

L’objectif de cette étude consistait à évaluer l’activité au système nerveux autonome pendant l’anesthésie épidurale haute et basse. Faisaient partie de l’étude: dix sujets opérés au membre inférieur sous anesthésie épidurale lombaire (groupe de l’épidurale basse; niveau métamérique cutané moyen bloqué, T10,7± 1,1 et dix sujets opérés soit pour hystérectomie abdominale totale ou cure de hernie inguinale sous épidurale lombaire (groupe de l’épidurale haute; niveau métamérique cutané moyen bloqué, T5± 1,0. Dix volontaires bien portants constituaient le groupe de contrôle. L’activité nerveuse autonome a été mesurée par la variabilité de la fréquence cardiaque et de la pression artérielle par analyse spectrale de puissance. Pour l’analyse de la variabilité de la fréquence cardiaque, les composantes des fréquences ont été divisées en deux facteurs: une composante RR de basse fréquence (LFCrr: 0,03 Hz–0,15 Hz) médiatrice de l’activité sympathique et parasympathique, et une composante de haute fréquence RR (HFCrr: 0,15 Hz–0,4 Hz) médiatrice de l’activité parasympathique. Pour l’analyse de la variabilité de la pression artérielle, les composantes des fréquences ont aussi été divisées en deux facteurs: une composante de basse fréquence de pressions artérielles systolique et diastolique (LFCsbp et LFCdbp) et une composante de haute fréquence des pressions systolique et diaslolique (HFCsbp et HFCdbp: 0,15 Hz–0,4 Hz) médiatrice d’un effet mécanique de la respiration. La variabilité de la fréquence cardiaque n’a pas changé pendant l’anesthésie épidurale. Cependant, les LFCsbp et LFCdbp ont diminué pendant l’épidurale haute (P < 0,01). Nous concluons que l’activité vasomotrice sympathique périphérique était activée pendant l’épidurale basse et supprimée pendant l’épidurale haute.

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Copyright information

© Canadian Anesthesiologists 1994

Authors and Affiliations

  • Masayuki Arakawa
    • 1
  • Fumio Goto
    • 1
  1. 1.Department of AnesthesiologyKitasato University School of MedicineKanagawaJapan

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