Respiratory sinus arrhythmia and clinical signs of anaesthesia in children.

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.

[1]  Stephen W. Porges,et al.  Respiratory Sinus Arrhythmia: Physiological Basis, Quantitative Methods, and Clinical Implications , 1986 .

[2]  D. Giddens,et al.  Heart Rate Variability Analysis in Full-Term Infants: Spectral Indices for Study of Neonatal Cardiorespiratory Control , 1989, Pediatric Research.

[3]  T E Healy,et al.  Respiratory sinus arrhythmia: an index of light anaesthesia. , 1993, British journal of anaesthesia.

[4]  T. Latson,et al.  Effects of surgical stimulation on autonomic reflex function: assessment by changes in heart rate variability. , 1993, British journal of anaesthesia.

[5]  D. Adam,et al.  Assessment of autonomic function in humans by heart rate spectral analysis. , 1985, The American journal of physiology.

[6]  R. Cohen,et al.  An Efficient Algorithm for Spectral Analysis of Heart Rate Variability , 1986, IEEE Transactions on Biomedical Engineering.

[7]  D C Smith,et al.  The auditory evoked potential and paediatric anaesthesia. , 1995, British journal of anaesthesia.

[8]  M. N. Levy,et al.  Neuropeptide Y as a Putative Modulator of the Vagal Effects on Heart Rate , 1989, Circulation research.

[9]  D. Lipson,et al.  Opposing central and peripheral effects of atropine on parasympathetic cardiac control. , 1977, The American journal of physiology.

[10]  J. Cacioppo,et al.  Respiratory sinus arrhythmia: autonomic origins, physiological mechanisms, and psychophysiological implications. , 1993, Psychophysiology.

[11]  H. Hoff,et al.  THE EFFECT OF PREANESTHETIC AND ANESTHETIC AGENTS ON THE RESPIRATION-HEART RATE RESPONSE OF DOGS. , 1965, American journal of veterinary research.

[12]  R. Cohen,et al.  Hemodynamic regulation: investigation by spectral analysis. , 1985, The American journal of physiology.

[13]  Y. Donchin,et al.  Respiratory Sinus Arrhythmia during Recovery from Isoflurane—Nitrous Oxide Anesthesia , 1985, Anesthesia and analgesia.

[14]  D. Galletly,et al.  Effect of halothane, isoflurane and fentanyl on spectral components of heart rate variability. , 1994, British journal of anaesthesia.

[15]  M. Kato,et al.  Spectral analysis of heart rate variability during isoflurane anesthesia. , 1992, Anesthesiology.

[16]  D. Galletly,et al.  Heart rate periodicities during induction of propofol-nitrous oxide-isoflurane anaesthesia. , 1992, British journal of anaesthesia.

[17]  H. H. Ros,et al.  Effects of thiopentone, etomidate and propofol on beat‐to‐beat cardiovascular signals in man , 1993, Anaesthesia.

[18]  R. Cohen,et al.  Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. , 1981, Science.

[19]  M. Turiel,et al.  Power Spectral Analysis of Heart Rate and Arterial Pressure Variabilities as a Marker of Sympatho‐Vagal Interaction in Man and Conscious Dog , 1986, Circulation research.