open access

Vol 48, No 4 (2016)
Original and clinical articles
Published online: 2016-09-30
Submitted: 2016-06-20
Accepted: 2016-09-12
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Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Tomoki Nishiyama
DOI: 10.5603/AIT.a2016.0041
·
Anaesthesiol Intensive Ther 2016;48(4):248-251.

open access

Vol 48, No 4 (2016)
Original and clinical articles
Published online: 2016-09-30
Submitted: 2016-06-20
Accepted: 2016-09-12

Abstract

BACKGROUND: The purpose of this study was to compare cardiac sympathetic and parasympathetic balance using heart rate variability (HRV) during induction of anaesthesia between sevoflurane and isoflurane in combination with nitrous oxide.

METHODS: 40 individuals aged from 30 to 60 years, scheduled for general anaesthesia were equally divided into sevoflurane or isoflurane groups. After 100% oxygen inhalation for a few minutes, anaesthesia was induced with nitrous oxide 3 L min-1, oxygen 3 L min-1 and sevoflurane or isoflurane. Sevoflurane or isoflurane concentration was increased by 0.5% every 2 to 3 breaths until 5% was attained for sevoflurane, or 3% for isoflurane. Vecuronium was administered to facilitate tracheal intubation. After intubation, sevoflurane was set to 2% while isoflurane was set to 1% with nitrous oxide with oxygen (1:1) for 5 min.

RESULTS: Both sevoflurane and isoflurane provoked a decrease in blood pressure, total power, the low frequency component (LF), and high frequency component (HF) of HRV. Although the heart rate increased during isoflurane anaesthesia, it decreased under sevoflurane. The power of LF and HF also decreased in both groups. LF was higher in the isoflurane group while HF was higher in the sevoflurane group. The LF/HF ratio increased transiently in the isoflurane group, but decreased in the sevoflurane group.

CONCLUSION: Anaesthesia induction with isoflurane-nitrous oxide transiently increased cardiac sympathetic activity, while sevoflurane-nitrous oxide decreased both cardiac sympathetic and parasympathetic activities. The balance of cardiac parasympathetic/sympathetic activity was higher in sevoflurane anaesthesia.

Abstract

BACKGROUND: The purpose of this study was to compare cardiac sympathetic and parasympathetic balance using heart rate variability (HRV) during induction of anaesthesia between sevoflurane and isoflurane in combination with nitrous oxide.

METHODS: 40 individuals aged from 30 to 60 years, scheduled for general anaesthesia were equally divided into sevoflurane or isoflurane groups. After 100% oxygen inhalation for a few minutes, anaesthesia was induced with nitrous oxide 3 L min-1, oxygen 3 L min-1 and sevoflurane or isoflurane. Sevoflurane or isoflurane concentration was increased by 0.5% every 2 to 3 breaths until 5% was attained for sevoflurane, or 3% for isoflurane. Vecuronium was administered to facilitate tracheal intubation. After intubation, sevoflurane was set to 2% while isoflurane was set to 1% with nitrous oxide with oxygen (1:1) for 5 min.

RESULTS: Both sevoflurane and isoflurane provoked a decrease in blood pressure, total power, the low frequency component (LF), and high frequency component (HF) of HRV. Although the heart rate increased during isoflurane anaesthesia, it decreased under sevoflurane. The power of LF and HF also decreased in both groups. LF was higher in the isoflurane group while HF was higher in the sevoflurane group. The LF/HF ratio increased transiently in the isoflurane group, but decreased in the sevoflurane group.

CONCLUSION: Anaesthesia induction with isoflurane-nitrous oxide transiently increased cardiac sympathetic activity, while sevoflurane-nitrous oxide decreased both cardiac sympathetic and parasympathetic activities. The balance of cardiac parasympathetic/sympathetic activity was higher in sevoflurane anaesthesia.

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Keywords

general anaesthesia, induction, volatile; volatile anaesthetics, sevoflurane, isoflurane; autonomic nervous system; heart rate variability

About this article
Title

Changes in heart rate variability during anaesthesia induction using sevoflurane or isoflurane with nitrous oxide

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 4 (2016)

Pages

248-251

Published online

2016-09-30

DOI

10.5603/AIT.a2016.0041

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(4):248-251.

Keywords

general anaesthesia
induction
volatile
volatile anaesthetics
sevoflurane
isoflurane
autonomic nervous system
heart rate variability

Authors

Tomoki Nishiyama

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