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BJA Advance Access originally published online on April 9, 2008
British Journal of Anaesthesia 2008 100(6):772-779; doi:10.1093/bja/aen080
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Increased non-stationarity of heart rate during general anaesthesia with sevoflurane or desflurane in children

M.-K. Yum1, J.-T. Kim2 and H.-S. Kim2,*

1 Department of Pediatrics, Hanyang University College of Medicine, Seoul, South Korea
2 Department of Anesthesiology, Seoul National University College of Medicine, #28 Yongon-dong, Jongno-gu, Seoul 110-744, South Korea

* Corresponding author. E-mail: dami0605{at}snu.ac.kr

Background: During general anaesthesia, the most prominent change in heart rate variability (HRV) is a decrease in the magnitude of heart rate (HR) oscillation in the high- and low-frequency ranges. In children receiving sevoflurane or desflurane, we observed a significant increase in HR non-stationarity, that is, a significant change of mean HR over time. The aim of our study was to describe this increased non-stationarity and compare it with the decrease in the magnitude of HR oscillation.

Methods: Sixty children received sevoflurane (n=30) or desflurane anaesthesia (n=30). The magnitude of HR oscillation and non-stationarity during pre-anaesthesia and anaesthesia were measured by spectral and Hurst analyses using structure function, respectively.

Results: Low- and high-frequency powers decreased significantly and the very-short-term (2≤{tau}≤8 s, H{alpha}) and short-term Hurst exponent (8≤{tau}≤45 s, Hβ) increased significantly during the anaesthetic period compared with the pre-anaesthetic period, regardless of the anaesthetic agent [sevoflurane: mean (SD) H{alpha} 0.414 (0.169) vs 0.252 (0.0655), Hβ 0.481 (0.169) vs 0.078 (0.0409); desflurane H{alpha} 0.336 (0.171) vs 0.261 (0.0614), Hβ 0.471 (0.221) vs 0.0813 (0.049)]. Stepwise discriminant analysis showed that the short-term Hurst exponent was better than the spectral indices at differentiating between the pre-anaesthetic period and anaesthetic period.

Conclusions: During sevoflurane and desflurane anaesthesia in children, there is a significant increase in very-short-term and short-term HR non-stationarity. Furthermore, the greater short-term non-stationarity differentiates better between the pre-anaesthesia and anaesthesia than the decreased magnitude of HR oscillation in the high- and low-frequency ranges.

Keywords: anaesthetics volatile, sevoflurane, desflurane; children; heart, heart rate


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