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The effects of surgical levels of sevoflurane and propofol anaesthesia on heart rate variability

Published online by Cambridge University Press:  01 July 2007

M. Mäenpää ,
J. Penttilä ,
T. Laitio ,
K. Kaisti ,
T. Kuusela ,
S. Hinkka  and
H. Scheinin
M. Mäenpää*
Affiliation:
Turku University Hospital, Department of Surgery, Turku, Finland
J. Penttilä
Affiliation:
Päijät-Häme Central Hospital, Department of Adolescent Psychiatry, Lahti, Finland
T. Laitio
Affiliation:
Turku University Hospital, Department of Anaesthesiology and Intensive Care, Turku, Finland
K. Kaisti
Affiliation:
Turku University Hospital, Department of Anaesthesiology and Intensive Care, Turku, Finland
T. Kuusela
Affiliation:
University of Turku, Department of Physics, Turku, Finland
S. Hinkka
Affiliation:
University of Turku, Department of Biostatistics, Turku, Finland
H. Scheinin
Affiliation:
Turku PET Centre, and the Department of Pharmacology and Clinical Pharmacology, Turku, Finland
*
Correspondence to: Mika Mäenpää, Department of Surgery, Turku University Hospital, Puolalanpuisto 3 A 1, FIN-20100 Turku, Finland. E-mail: mika.eero.maenpaa@utu.fi; Tel: +358 40 5789446; Fax: +358 2 231 8191
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Summary

Background and objective

We compared heart rate dynamics during surgical levels of propofol and sevoflurane anaesthesia in a highly standardized setting.

Methods

We recorded electrocardiography from 24 anaesthetized healthy male subjects. In the first parallel part of the study, the subjects were anaesthetized either with sevoflurane (n = 8) or propofol (n = 8) targeted to match 1.0, 1.5 and 2.0 minimal alveolar concentration/effective concentration 50. In the second part, a separate group (n = 8) underwent four different anaesthetic regimens targeted to bispectral index 40: sevoflurane alone, sevoflurane + 70% nitrous oxide, propofol alone and propofol + 70% nitrous oxide. The electrocardiography data were analysed using conventional time and frequency domain methods, and the approximate entropy method, which estimates the complexity of the data.

Results

The induction of anaesthesia was followed by an overall reduction of heart rate variability, evident in all frequency bands in the spectral analysis, and also in the time domain measures. Approximate entropy decreased at 1 effective concentration 50 with propofol and at 2 minimal alveolar concentration with sevoflurane. In the second part of the study, the time domain variables and high-frequency spectral power were all similarly reduced by sevoflurane and propofol anaesthesia, with and without nitrous oxide. Approximate entropy tended to decrease during propofol anaesthesia.

Conclusions

Hypnotic levels of sevoflurane and propofol anaesthesia suppressed the heart rate variability measured using conventional analysis methods. Deeper surgical levels of anaesthesia also reduce the complexity of heart rate variability.

Keywords

ANAESTHESIA INHALATIONALANAESTHESIA INTRAVENOUSPROPOFOLSEVOFLURANECARDIOVASCULAR PHYSIOLOGY, heart rate variability
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 7 , July 2007 , pp. 626 - 633
Copyright
Copyright © European Society of Anaesthesiology 2007

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