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전신 마취 중 심박동변이도와 맥파전달시간 변화의 비교

Comparison of Heart Rate Variability with Pulse Transit Time during General Anesthesia

  • 백승완 (부산대학교 의학전문대학원 마취통증의학교실) ;
  • 김태균 (부산대학교 의학전문대학원 마취통증의학교실) ;
  • 김재형 (인제대학교 컴퓨터응용과학부) ;
  • 전계록 (부산대학교 의학전문대학원 의공학교실) ;
  • 예수영 (부산대학교 의학전문대학원 BK21 고급의료인력양성사업단)
  • 발행 : 2008.08.01

초록

Autonomic nervous system of the anesthetized patients can be influenced by the many kinds of stimulations such as intubation, surgical incision and so on. The changes of the heart rates and blood pressures are surrogates of responses of the autonomic system to the external stimulations. Recently, the power spectral analysis of the heart rate variability (HRV) made it easy to know the fractions and changes of sympathetic and parasympathetic autonomic systems. In this study, the changes of pulse transit time, one of the response of vessels to stimulations, was investigated in relation to the HRV. Ten patients were examined and average age is 22.5 $\pm$ 11.04, average weight is 63 $\pm$ 14.4 kg. The patients were anesthetized only by sevoflurane inhalation. Pulse transit time is determined by calculating the difference of the time between the R peak of ECG and the characteristic point of the plethysmography. Power spectral density (PSD) of the HRV was achieved in the frequency of 0.04-0.15 (LF) and 0.15-0.4 (HF). Compared to preanesthetic period the values of LF and LF/HF ratio of HRV were decreased (p<0.05). HF and PTT was increased in anesthetic state with sevoflurane. Otherwise, after intubation, the HF was decreased and LF, LF/HF ratio and PTT were increased. PSD of the HRV is well-known for the index of the autonomic nervous activity. Not only HRV but PTT analysis also is a useful index reflecting the autonomic responses to various stimulations. And this analysis is useful in bed side monitoring because the calculating method is simple and it takes shorter processing time compared to the HRV analysis.

키워드

참고문헌

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