Hsu Che-Hao, Tsai Ming-Ya, Huang Go-Shine, Lin Tso-Chou, Chen Kuen-Pao, Ho Shung-Tai, Shyu Liang-Yu, Li Chi-Yuan
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Acta Anaesthesiol Taiwan. 2012 Mar;50(1):12-8. doi: 10.1016/j.aat.2012.03.002. Epub 2012 Apr 3.
Beat-to-beat heart rate variability (HRV) is caused by the fluctuating balance of sympathetic and parasympathetic tone. The Poincaré plot has been used to evaluate HRV. In this study, we validate that this new method may qualitatively and quantitatively assess the sympathovagal fluctuation in patients during induction of anesthesia with sevoflurane.
Twenty-eight young patients were allocated for the study. The patients received a tilt test and on the next day they sustained anesthesia induced with inhaled anesthetics. Electrocardiography signals from the patients were relayed to an analogue-digital converter. The Poincaré plot is quantified by measuring SD1, SD2, and SD1/SD2. Power spectral analyses were performed and LF, HF and HF/LF were calculated.
The LF power and the SD2 of the Poincaré plot increased while subjects were tilt-up from the supine position. Additionally, a significant correlation were found between LF and SD2, HF and SD1 (p < 0.05), and LF/HF and SD2/SD1 (p < 0.01). Sevoflurane inhalation for 10 minutes had no effect on heart rate, but diminished LF, total power and SD1, SD2 of the Poincaré plot respectively. However, the LF, SD2 and LF/HF increased; the HF, SD1 and SD1/SD2 ratio decreased after intubation stimulation.
Poincaré plot and power spectral analysis of HRV during tilt test and sevoflurane induction significantly correlate. Poincaré plot analysis is easier and more sensitive at evaluating the sympathovagal balance and observing the beat-to-beat HRV.
逐搏心率变异性（HRV）由交感神经和副交感神经张力的波动平衡引起。庞加莱图已用于评估HRV。在本研究中，我们验证了这种新方法可定性和定量评估七氟醚麻醉诱导期间患者的交感迷走神经波动。
28例年轻患者被分配到本研究中。患者接受倾斜试验，次日接受吸入麻醉诱导。患者的心电图信号被传输到模拟数字转换器。通过测量SD1、SD2和SD1/SD2对庞加莱图进行量化。进行功率谱分析并计算低频（LF）、高频（HF）和HF/LF。
当受试者从仰卧位倾斜起身时，庞加莱图的LF功率和SD2增加。此外，发现LF与SD2、HF与SD1之间存在显著相关性（p < 0.05），以及LF/HF与SD2/SD1之间存在显著相关性（p < 0.01）。吸入七氟醚10分钟对心率无影响，但分别降低了庞加莱图的LF、总功率以及SD1、SD2。然而，插管刺激后LF、SD2和LF/HF增加；HF、SD1和SD1/SD2比值降低。
倾斜试验和七氟醚诱导期间HRV的庞加莱图和功率谱分析显著相关。庞加莱图分析在评估交感迷走神经平衡和观察逐搏HRV方面更容易且更敏感。
