Blues C M, Pomfrett C J
Department of Anaesthesia, University of Manchester, Manchester Royal Infirmary.
Br J Anaesth. 1998 Sep;81(3):333-7. doi: 10.1093/bja/81.3.333.
We have investigated changes in respiratory sinus arrhythmia (RSA) and compared these with clinical signs of anaesthesia in children. Children aged 3-10 yr were anaesthetized by gaseous induction with halothane and nitrous oxide. Multiple heart rate variability (HRV) spectra were obtained by power spectral analysis of continuous epochs of time from before introduction of halothane (baseline) until the pupils were central and fixed (stage 3). Measurement of RSA was performed by integration of the area under the spectral curve within the range of the respiratory frequency +/- 0.15 Hz. In all patients RSA decreased continuously during induction unless stimulation occurred with insertion of an airway. Values of RSA were compared at three times: baseline, loss of pharyngeal tone and stage 3. The decrease in RSA from baseline to loss of pharyngeal tone and from loss of pharyngeal tone to stage 3 was significant (P = 0.003 and P = 0.018, respectively). These results show that RSA can be related to the clinical signs of anaesthesia and has potential as a measure of depth of anaesthesia in children.
我们研究了呼吸性窦性心律不齐（RSA）的变化，并将其与儿童麻醉的临床体征进行了比较。3至10岁的儿童通过氟烷和氧化亚氮进行气体诱导麻醉。通过对从引入氟烷之前（基线）到瞳孔居中并固定（第3阶段）的连续时间段进行功率谱分析，获得多个心率变异性（HRV）谱。通过对呼吸频率±0.15 Hz范围内的频谱曲线下面积进行积分来测量RSA。在所有患者中，诱导期间RSA持续下降，除非在插入气道时发生刺激。在三个时间点比较RSA值：基线、咽反射消失和第3阶段。从基线到咽反射消失以及从咽反射消失到第3阶段，RSA的下降具有显著性（分别为P = 0.003和P = 0.018）。这些结果表明，RSA可能与麻醉的临床体征相关，并且有潜力作为儿童麻醉深度的一种测量指标。
