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British Journal of Anaesthesia, 1994, Vol. 72, No. 6 643-649
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Prolonged decrease in heart rate variability after elective hip arthroplasty

S. C. U. MARSCH, M.D., K. SKARVAN, M.D., H.-G. SCHAEFER, M.D., F.R.C.A., B. NAEGELI, M.D.{dagger}, R. PAGANONI, M.D., I. CASTELLI, M.D.{ddagger} and D. SCHEIDEGGER, M.D.

Department of Anaesthesia Kantonsspital, 4301 Basel, Switzerland
{dagger}Department of Cardiology Kantonsspital, 4031 Basel, Switzerland
{ddagger}Kantonsspital Olten 4600 Olten, Switzerland

Correspondence to S.C.U.M.

The pattern of postoperative heart rate variability may provide insight into the response of the autonomic nervous system to anaesthesia and surgery. We have obtained spectral (fast Fourier transform) and non-spectral indices of heart rate variability from electrocardiographic recordings, sampled during continuous perioperative Holter monitoring in 15 otherwise healthy patients with an uncomplicated postoperative course, undergoing elective hip arthroplasty with either spinal or general anaesthesia. In both groups, total spectral energy (0.01–1 Hz), low-frequency spectral energy (0.01–0.15 Hz) and high-frequency spectral energy (0.15–0.40 Hz) decreased after surgery to 32% (95% confidence interval (Cl) 10.5; P <0.01), 29% (95% Cl 12.5; P <0.07; and 33% (95% Cl 12.5; P <0.01) of their preoperative values, respectively, and these indices remained suppressed for up to 5 days. Non-spectral indices decreased to a similar extent. These findings indicate a substantial and prolonged postoperative decrease in both parasympathetic and sympathetic influence on the sinus node.


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