Tetzlaff J E, O'Hara J, Yoon H J, Schubert A
Department of General Anesthesiology, Cleveland Clinic Foundation, OH 44195, USA.
J Clin Anesth. 1997 Mar;9(2):138-42. doi: 10.1016/S0952-8180(97)00238-9.
To determine the autonomic changes associated with pneumatic tourniquet-induced hypertension as measured by power spectral heart rate analysis (PSHR).
Prospective study.
Tertiary teaching hospital.
21 healthy-patients scheduled for lower extremity surgery, during which pneumatic tourniquet inflation was expected to exceed 90 minutes.
Hemodynamic and PSHR data collected at 5 minute intervals during inflation of the pneumatic tourniquet. Tourniquet-induced hypertension (T-HTN) defined at 30% increase above baseline.
Blood pressure, heart rate, maximum changes in low frequency variability (LFa), high frequency variability (HFa), and their ratio (LFa/HFa) were measured. Of the 21 patients, 11 had T-HTN. A significantly greater increase in LFa and LFa/HFa ratio was seen in the T-HTN group, where patients were greater in age. LFa, HFa, and ratio were not significantly different with T-HTN until 60 minutes or greater. Best correlation with T-HTN occurred with maximum increase in LFa/HFa ratio compared with increase in LFa or decrease in HFa.
Tourniquet hypertension correlated with activation of the sympathetic nervous systems, as measured by PSHR variables.
通过功率谱心率分析（PSHR）确定与气压止血带诱发高血压相关的自主神经变化。
前瞻性研究。
三级教学医院。
21例计划进行下肢手术的健康患者，预计气压止血带充气时间超过90分钟。
在气压止血带充气期间每隔5分钟收集血流动力学和PSHR数据。止血带诱发高血压（T-HTN）定义为比基线升高30%。
测量血压、心率、低频变异性（LFa）、高频变异性（HFa）的最大变化及其比值（LFa/HFa）。21例患者中，11例发生T-HTN。T-HTN组LFa和LFa/HFa比值升高更为显著，且该组患者年龄更大。在60分钟或更长时间之前，LFa、HFa及其比值与T-HTN无显著差异。与T-HTN相关性最好的是LFa/HFa比值的最大升高，而非LFa升高或HFa降低。
通过PSHR变量测量，止血带高血压与交感神经系统激活相关。
