Spectral analysis of sudden bradycardia during intrathecal meperidine anesthesia
Publication in refereed journal


香港中文大学研究人员 ( 现职)

郭志德教授 (麻醉及深切治疗学系)

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数位物件识别号 (DOI) http://dx.doi.org/10.1016/S1098-7339(98)90036-0

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Web of Sciencehttp://aims.cuhk.edu.hk/converis/portal/Publication/4WOS source URL

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摘要Background and Objectives. Severe bradycardia occurring suddenly during spinal anesthesia,although rare, is potentially fatal. Bradycardias are more common after intrathecal meperidine. We report two such episodes occurring in elderly male patients undergoing transurethral surgery. Methods. Subarachnoid block was provided using 50 mg meperidine. Autonomic function was assessed by measuring heart rate (HR) variability using R-R intervals from standard electrocardiographic recordings. Frequency-domain spectra were constructed from 512 heartbeats, and an autoregressive method was used to calculate spectral power. Results. In both patients, bradycardia (HR <50 beats/min) occurred after about 10 minutes and was associated with severe hypotension and a 10- to 100-fold increase in spectral density in both the low (0.0http://aims.cuhk.edu.hk/converis/portal/Publication/4-0.15 Hz), mainly sympathetic, and the high (0.15-0.http://aims.cuhk.edu.hk/converis/portal/Publication/40 Hz), mainly parasympathetic, frequency bands. These spectral increases were subsequently attenuated by intravenous atropine. Heart rate slowing was noted to be periodic, or oscillatory, in one patient. Conclusion. Sudden increases in vagal, or parasympathetic, activity probably accounted for bradycardia.

着者Critchley LAH, Chan S, Tam YH
期刊名称Regional Anesthesia and Pain Medicine
出版年份1998
月份9
日期1
卷号23
期次5
出版社CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
页次506 - 510
国际标準期刊号1098-7339
电子国际标準期刊号1532-8651
语言英式英语

关键词bradycardia; heart rate variability; meperidine; spectral analysis; subarachnoid anesthesia
Web of Science 学科类别Anesthesiology; ANESTHESIOLOGY