Respiratory Sinus Arrhythmia: A New, Objective Sedation Score

Wang, D.Y.; Pomfrett, C.J.D.; Healy, T.E.J.

doi:10.1093/bja/71.3.354

Cited by 31 publications

(15 citation statements)

References 11 publications

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“…This has led to speculation that HRV could be used to monitor the depth of anaesthesia, and particularly to avoid superficial levels of anaesthesia [83]. This idea is supported by the increase in HRV that is seen with surgical stimuli or intubation and at the end of anaesthesia [84][85][86]. But these results have been interpreted in different ways.…”

Section: Heart Rate Variabilitymentioning

confidence: 99%

Transcranial cerebral oximetry, transcranial Doppler sonography, and heart rate variability: useful neuromonitoring tools in anaesthesia and intensive care?

Schwarz

Litscher

2002

EJA

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Section: Heart Rate Variabilitymentioning

confidence: 99%

Transcranial cerebral oximetry, transcranial Doppler sonography, and heart rate variability: useful neuromonitoring tools in anaesthesia and intensive care?

Schwarz

Litscher

2002

EJA

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“…RSA diminishes during propofol sedation [64], propofol anaesthesia [65] and isoflurane anaesthesia [66] and therefore it has been suggested that measurement of RSA could be a useful index of anaesthetic depth. Changes in RSA however depend upon the activity of the brainstem and the action of the anaesthetic agents thereupon, yet consciousness and memory arise from higher centres within the central nervous system.…”

Section: Respiratory Sinus Arrhythmiamentioning

confidence: 99%

Patients' memories of events during general anaesthesia

Bailey

Jones

1997

Anaesthesia

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SummaryAwareness remains a serious complication of general anaesthesia with potential adverse psychological sequelae. Even during seemingly adequate general anaesthesia, implicit memory may be retained along with the ability to subconsciously process auditory stimuli. As a result behaviour may be modified and postoperative progress influenced. We shall discuss the structure of memory and the effects of increasing doses of general anaesthesia on cognitive processes. In addition methods of assessing the depth of anaesthesia will be reviewed.

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“…It has been suggested that the depth of anaesthesia has an effect on the function of the autonomic nervous system. Several groups have claimed that monitoring heart rate variability, and RSA in particular, is useful in determining the depth of anaesthesia [5][6][7][8][9]. Numerous indices have been derived to describe the overall variation in heart rate [10].…”

Section: Introductionmentioning

confidence: 99%

Respiratory sinus arrhythmia during anaesthesia: assessment of respiration related beat-to-beat heart rate variability analysis methods

Loula

Jäntti

Yli‐Hankala

1997

Int. J. Clin. Mon. Comp.

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Beat-to-beat heart rate variability analysis is a powerful tool for the diagnosis of neuropathy. Respiration-related heart rate variability (respiratory sinus arrhythmia, RSA) reflects the function of parasympathetic nervous system during spontaneous ventilation while awake. RSA is also claimed to monitor the depth of anaesthesia. Power spectrum analysis or various averaging techniques of the heart rate variability are usually applied. The current literature, however, does not usually interpret the ground rules and limitations of the method used, and this may sometimes lead to erroneous conclusions on the data. The aim of our study was to compare and analyse critically the performance of different methods of evaluating RSA during anaesthesia and positive pressure ventilation. Power spectrum analysis, the root mean square of the successive RR-interval difference (RMSSD), and two respiration related methods, RSA index and average phase RSA, were included in the comparison. To test these methods, 11 patients were anaesthetised with isoflurane and their lungs were ventilated mechanically with a frequency of 6 cycles min-1. Each patient received a bolus dose of atropine (20 micrograms kg-1) during the trial. Electrocardiogram, electroencephalogram and tracheal pressure signal from respirator were recorded and analyses were performed off-line. We demonstrated that general indices, such as RMSSD, may be strongly affected by heart rate level and other non-respiration related variations in heart rate. We also showed that the effect of unwanted fluctuations on RSA can be reduced with respiration dependent beat-to-beat methods. Furthermore we confirmed that in addition to the amplitude, also the pattern of respiratory sinus arrhythmia is of interest: the pattern is reversed in phase compared to spontaneous breathing while awake, as we have shown earlier. To analyse RSA during anaesthesia, we recommend the use of an average phase RSA method based on beat-to-beat variability that shows both the amplitude and pattern of RSA. Finally, no measure of RSA should be used without a presentation of the actual beat-to-beat heart rate curve.

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Respiratory Sinus Arrhythmia: A New, Objective Sedation Score

Cited by 31 publications

References 11 publications

Transcranial cerebral oximetry, transcranial Doppler sonography, and heart rate variability: useful neuromonitoring tools in anaesthesia and intensive care?

Transcranial cerebral oximetry, transcranial Doppler sonography, and heart rate variability: useful neuromonitoring tools in anaesthesia and intensive care?

Patients' memories of events during general anaesthesia

Respiratory sinus arrhythmia during anaesthesia: assessment of respiration related beat-to-beat heart rate variability analysis methods

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