1
|
Wujtewicz M, Twardowski P, Jasiński T, Michalska-Małecka K, Owczuk R. Evaluation of the Relationship between Baseline Autonomic Tone and Haemodynamic Effects of Dexmedetomidine. Pharmaceuticals (Basel) 2023; 16:354. [PMID: 36986456 PMCID: PMC10052810 DOI: 10.3390/ph16030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Dexmedetomidine, a central α-2 agonist, is used for procedural sedation and for conscious sedation influences on heart rate and blood pressure. Authors verified whether it is possible to predict bradycardia and hypotension with the use of heart rate variability (HRV) analysis for an autonomic nervous system (ANS) activity assessment. The study included adult patients of both sexes with an ASA score of I or II scheduled for ophthalmic surgery to be performed under sedation. The loading dose of dexmedetomidine was followed by a 15 min infusion of the maintenance dose. The frequency domain heart rate variability parameters from the 5-min Holter electrocardiogram recordings before dexmedetomidine administration were used for the analysis. The statistical analysis also included pre-drug heart rate and blood pressure as well as patient age and sex. The data from 62 patients were analysed. There was no relationship between the decrease in heart rate (42% of cases) and initial HRV parameters, haemodynamic parameters or sex and age of patients. In multivariate analysis, the only risk factor for a decrease in mean arterial pressure (MAP) > 15% from the pre-drug value (39% of cases) was the systolic blood pressure before dexmedetomidine administration as well as for a >15% decrease in MAP sustained at more than one consecutive time point (27% of cases). The initial condition of the ANS did not correlate with the incidence of bradycardia or hypotension; HRV analysis was not helpful in predicting the abovementioned side effects of dexmedetomidine.
Collapse
Affiliation(s)
- Magdalena Wujtewicz
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Paweł Twardowski
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin 9016, New Zealand
| | - Tomasz Jasiński
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | | | - Radosław Owczuk
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| |
Collapse
|
2
|
Cairo B, de Abreu RM, Bari V, Gelpi F, De Maria B, Rehder-Santos P, Sakaguchi CA, da Silva CD, De Favari Signini É, Catai AM, Porta A. Optimizing phase variability threshold for automated synchrogram analysis of cardiorespiratory interactions in amateur cyclists. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200251. [PMID: 34689616 DOI: 10.1098/rsta.2020.0251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/13/2023]
Abstract
We propose a procedure suitable for automated synchrogram analysis for setting the threshold below which phase variability between two marker event series is of such a negligible amount that the null hypothesis of phase desynchronization can be rejected. The procedure exploits the principle of maximizing the likelihood of detecting phase synchronization epochs and it is grounded on a surrogate data approach testing the null hypothesis of phase uncoupling. The approach was applied to assess cardiorespiratory phase interactions between heartbeat and inspiratory onset in amateur cyclists before and after 11-week inspiratory muscle training (IMT) at different intensities and compared to a more traditional approach to set phase variability threshold. The proposed procedure was able to detect the decrease in cardiorespiratory phase locking strength during vagal withdrawal induced by the modification of posture from supine to standing. IMT had very limited effects on cardiorespiratory phase synchronization strength and this result held regardless of the training intensity. In amateur athletes training, the inspiratory muscles did not limit the decrease in cardiorespiratory phase synchronization observed in the upright position as a likely consequence of the modest impact of this respiratory exercise, regardless of its intensity, on cardiac vagal control. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
Collapse
Affiliation(s)
- Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - Raphael Martins de Abreu
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Vlasta Bari
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - Francesca Gelpi
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | | | - Patrícia Rehder-Santos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Camila Akemi Sakaguchi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Claudio Donisete da Silva
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Étore De Favari Signini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| |
Collapse
|
3
|
Hayase K, Kainuma A, Akiyama K, Kinoshita M, Shibasaki M, Sawa T. Poincaré Plot Area of Gamma-Band EEG as a Measure of Emergence From Inhalational General Anesthesia. Front Physiol 2021; 12:627088. [PMID: 33633587 PMCID: PMC7900422 DOI: 10.3389/fphys.2021.627088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/05/2021] [Indexed: 12/18/2022] Open
Abstract
The Poincaré plot obtained from electroencephalography (EEG) has been used to evaluate the depth of anesthesia. A standalone EEG Analyzer application was developed; raw EEG signals obtained from a bispectral index (BIS) monitor were analyzed using an on-line monitoring system. Correlations between Poincaré plot parameters and other measurements associated with anesthesia depth were evaluated during emergence from inhalational general anesthesia. Of the participants, 20 were adults anesthetized with sevoflurane (adult_SEV), 20 were adults anesthetized with desflurane (adult_DES), and 20 were pediatric patients anesthetized with sevoflurane (ped_SEV). EEG signals were preprocessed through six bandpass digital filters (f0: 0.5–47 Hz, f1: 0.5–8 Hz, f2: 8–13 Hz, f3: 13–20 Hz, f4: 20–30 Hz, and f5: 30–47 Hz). The Poincaré plot-area ratio (PPAR = PPA_fx/PPA_f0, fx = f1∼f5) was analyzed at five frequency ranges. Regardless of the inhalational anesthetic used, there were strong linear correlations between the logarithm of PPAR at f5 and BIS (R2 = 0.67, 0.79, and 0.71, in the adult_SEV, adult_DES, and ped_SEV groups, respectively). As an additional observation, a part of EMG activity at the gamma range of 30–47 Hz probably influenced the calculations of BIS and PPAR_f5 with a non-negligible level. The logarithm of PPAR in the gamma band was most sensitive to state changes during the emergence process and could provide a new non-proprietary parameter that correlates with changes in BIS during measurement of anesthesia depth.
Collapse
Affiliation(s)
- Kazuma Hayase
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Akiyama
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masayuki Shibasaki
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
4
|
Perry S, Khovanova N, Khovanov I. Physical fitness contributes to cardio-respiratory synchronization. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4957-4960. [PMID: 31946972 DOI: 10.1109/embc.2019.8857193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cardio-respiratory synchronization is a phenomenon of particular interest- especially at a 1:1 ratio- and may give greater insight into the underlying mechanisms of cardio-respiratory communication. Synchronization of this ratio is hypothesised to occur when breathing rate exceeds heart rate, which is the premise of this research. A novel experimental design focused on guiding elevated respiration to induce the entrainment of heart rate, and produce an equivalent rise in value. Application of instantaneous phase for identification and analysis of synchronization allowed for a reliable method of measuring the interaction between these stochastic processes. We have identified 1:1 phase synchronization in all volunteers measured. Longer synchronization episodes were observed reliably in athletic individuals, corroborating previous research for spontaneous breathing. This observation suggests that cardio-respiratory synchronization at all respiration rates is associated with a common underlying communication mechanism. Furthermore, it presents cardio-respiratory synchronization as a potential future measurement of fitness and autonomic health.
Collapse
|
5
|
Vizcardo M, Jiménez J, Alvarez E, Moleiro F, Rodríguez A, Octavio A. Nonlinear characterization of ECGs in patients with Chagas’ disease. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab03f7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
6
|
Wu Y, Jin S, Zhang L, Cheng J, Hu X, Chen H, Zhang Y. Minimum Alveolar Concentration-Awake of Sevoflurane Is Decreased in Patients With End-Stage Renal Disease. Anesth Analg 2019; 128:77-82. [DOI: 10.1213/ane.0000000000003676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
7
|
Lioi G, Bell SL, Smith DC, Simpson DM. Measuring depth of anaesthesia using changes in directional connectivity: a comparison with auditory middle latency response and estimated bispectral index during propofol anaesthesia. Anaesthesia 2018; 74:321-332. [PMID: 30556186 DOI: 10.1111/anae.14535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2018] [Indexed: 12/20/2022]
Abstract
General anaesthesia is associated with changes in connectivity between different regions of the brain, the assessment of which has the potential to provide a novel marker of anaesthetic effect. We propose an index that quantifies the strength and direction of information flow in electroencephalographic signals collected across the scalp, assess its performance in discriminating 'wakefulness' from 'anaesthesia', and compare it with estimated bispectral index and the auditory middle latency response. We used a step-wise slow induction of anaesthesia in 10 patients to assess graded changes in electroencephalographic directional connectivity at propofol effect-site concentrations of 2 μg.ml-1 , 3 μg.ml-1 and 4 μg.ml-1 . For each stable effect-site concentration, connectivity was estimated from multichannel electroencephalograms using directed coherence, together with middle latency response and estimated bispectral index. We used a linear support vector machine classifier to compare the performance of the different electroencephalographic features in discriminating wakefulness from anaesthesia. We found a significant reduction in the strength of long-range connectivity (interelectrode distance > 10 cm) (p < 0.008), and a reversal of information flow from markedly postero-frontal to fronto-posterior (p < 0.006) between wakefulness and a propofol effect-site concentration of 2 μg.ml-1 . This then remained relatively constant as effect-site concentration increased, consistent with a step change in directed coherence with anaesthesia. This contrasted with the gradual change with increasing anaesthetic dose observed for estimated bispectral index and middle latency response. Directed coherence performed best in discriminating wakefulness from anaesthesia with an accuracy of 95%, indicating the potential of this new method (on its own or combined with others) for monitoring adequacy of anaesthesia.
Collapse
Affiliation(s)
- G Lioi
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK.,Post-Doc Univ Rennes, Inria, CNRS, IRISA, VisAGeS Project Team, F-35000, Rennes, France
| | - S L Bell
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - D C Smith
- Southampton General Hospital, University of Southampton, Southampton, UK
| | - D M Simpson
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| |
Collapse
|
8
|
Choi BM, Park C, Lee YH, Shin H, Lee SH, Jeong S, Noh GJ, Lee B. Development of a new analgesic index using nasal photoplethysmography. Anaesthesia 2018; 73:1123-1130. [PMID: 29790159 DOI: 10.1111/anae.14327] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
Although surrogate measures to quantify pain intensity have been commercialised, there is a need to develop a new index with improved accuracy. The aim of this study was to develop a new analgesic index using nasal photoplethysmography data. The specially designed sensor was placed between the columella and the nasal septum to acquire nasal photoplethysmography in surgical patients. Nasal photoplethysmography and Surgical Pleth Index® (GE Healthcare) data were obtained for 14 min both in the absence (pre-operatively) or presence (postoperatively) of pain in a group of surgical patients, each patient acting as their own control. Various dynamic photoplethysmography variables were extracted to quantify pain intensity; the most accurate index was selected using logistic regression as a classifier. The area under the curve of the receiver-operating characteristic curve was measured to evaluate the accuracy of final model predictions. In total, 12,012 heart beats from 89 patients were used to develop a new Nasal Photoplethysmography Index for analgesic depth quantification. The two-variable model (a combination of diastolic peak point variation and heart beat interval variation) was most accurate in discriminating between the presence and absence of pain (numerical rating scale (NRS) ≥ 3). The accuracy and area under the curve of the receiver-operating characteristic curve for the Nasal Photoplethysmography Index were 75.3% and 0.8018, respectively, and 64.8% and 0.7034, respectively, for the Surgical Pleth Index. The Nasal Photoplethysmography Index clearly distinguished pain (NRS ≥ 3) in awake surgical patients with postoperative pain. The Nasal Photoplethysmography Index performed better than the Surgical Pleth Index. Further validation studies are needed to evaluate its feasibility to quantify pain intensity during general anaesthesia.
Collapse
Affiliation(s)
- B M Choi
- Department of Anaesthesiology and Pain Medicine, Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - C Park
- School of Mechanical Engineering, Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Y H Lee
- Department of Anaesthesiology and Pain Medicine, Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - H Shin
- Department of Biomedical Engineering, Chonnam National University, Yeosu, South Korea
| | - S H Lee
- New Drug Development Center, Osong Medical Innovation Foundation, Chungcheongbuk-do, Korea
| | - S Jeong
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - G J Noh
- Department of Anesthesiology and Pain Medicine and Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - B Lee
- Department of Biomedical Science and Engineering, Institute of Integrated Technology, Gwangju Institute of Science and Technology, Gwangju, South Korea
| |
Collapse
|
9
|
Topçu Ç, Frühwirth M, Moser M, Rosenblum M, Pikovsky A. Disentangling respiratory sinus arrhythmia in heart rate variability records. Physiol Meas 2018; 39:054002. [DOI: 10.1088/1361-6579/aabea4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
10
|
Tzabazis A, Eisenried A, Yeomans DC, Hyatt MIV. Wavelet analysis of heart rate variability: Impact of wavelet selection. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.09.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Krause H, Kraemer JF, Penzel T, Kurths J, Wessel N. On the difference of cardiorespiratory synchronisation and coordination. CHAOS (WOODBURY, N.Y.) 2017; 27:093933. [PMID: 28964129 DOI: 10.1063/1.4999352] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
Cardiorespiratory phase synchronisation (CRS) is a type of cardiorespiratory coupling that manifests through a prediliction for heart beats to occur at specific points relative to the phase of the respiratory cycle. It has been under investigation for nearly 20 years, and while it seems to be mostly occurring in relaxed states such as deep sleep and anesthesia, no clear clinical implications have been established. Cardiorespiratory coordination (CRC) is a recent development in this field where the relationship between the respiratory onset and heart beat is analysed in the time domain and the possible relationship of each heart beat is considered for both the previous and the next respiratory onset. This ostensibly closely related effect must not only show relevant information content but also do so independent of CRS in order to be relevant for future studies. In this paper, we investigate CRC and its relation to CRS mainly using graphical and statistical methods on two exemplary datasets: measurements from a pregnant woman participating in a preeclampsia study and those from a man suffering from sleep apnea. We show fundamental differences between the results of both approaches and are able to show a formerly unknown dependency between the heart activity and respiratory rate, potentially indicating heartbeat-initiated inspiration. Despite their differences, methods developed for the quantification of CRS can be adapted to CRC. Completing the comparison is an investigation into the relationship between CRC and respiratory sinus arrhythmia. Similar to previous results for CRS, the two effects are found to be orthogonal, meaning that they can be observed independently or in conjunction.
Collapse
Affiliation(s)
- Harald Krause
- AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan F Kraemer
- AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Penzel
- AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Kurths
- AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Niels Wessel
- AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
12
|
Berg K, Kraemer JF, Riedl M, Stepan H, Kurths J, Wessel N. Increased cardiorespiratory coordination in preeclampsia. Physiol Meas 2017; 38:912-924. [DOI: 10.1088/1361-6579/aa64b0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
13
|
EEG artifacts reduction by multivariate empirical mode decomposition and multiscale entropy for monitoring depth of anaesthesia during surgery. Med Biol Eng Comput 2016; 55:1435-1450. [PMID: 27995430 DOI: 10.1007/s11517-016-1598-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Abstract
Electroencephalography (EEG) has been widely utilized to measure the depth of anaesthesia (DOA) during operation. However, the EEG signals are usually contaminated by artifacts which have a consequence on the measured DOA accuracy. In this study, an effective and useful filtering algorithm based on multivariate empirical mode decomposition and multiscale entropy (MSE) is proposed to measure DOA. Mean entropy of MSE is used as an index to find artifacts-free intrinsic mode functions. The effect of different levels of artifacts on the performances of the proposed filtering is analysed using simulated data. Furthermore, 21 patients' EEG signals are collected and analysed using sample entropy to calculate the complexity for monitoring DOA. The correlation coefficients of entropy and bispectral index (BIS) results show 0.14 ± 0.30 and 0.63 ± 0.09 before and after filtering, respectively. Artificial neural network (ANN) model is used for range mapping in order to correlate the measurements with BIS. The ANN method results show strong correlation coefficient (0.75 ± 0.08). The results in this paper verify that entropy values and BIS have a strong correlation for the purpose of DOA monitoring and the proposed filtering method can effectively filter artifacts from EEG signals. The proposed method performs better than the commonly used wavelet denoising method. This study provides a fully adaptive and automated filter for EEG to measure DOA more accuracy and thus reduce risk related to maintenance of anaesthetic agents.
Collapse
|
14
|
Affiliation(s)
- S W Choi
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - G T C Wong
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong Special Administrative Region
| |
Collapse
|
15
|
Stankovski T, Petkoski S, Raeder J, Smith AF, McClintock PVE, Stefanovska A. Alterations in the coupling functions between cortical and cardio-respiratory oscillations due to anaesthesia with propofol and sevoflurane. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2016; 374:rsta.2015.0186. [PMID: 27045000 PMCID: PMC4822446 DOI: 10.1098/rsta.2015.0186] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2016] [Indexed: 05/24/2023]
Abstract
The precise mechanisms underlying general anaesthesia pose important and still open questions. To address them, we have studied anaesthesia induced by the widely used (intravenous) propofol and (inhalational) sevoflurane anaesthetics, computing cross-frequency coupling functions between neuronal, cardiac and respiratory oscillations in order to determine their mutual interactions. The phase domain coupling function reveals the form of the function defining the mechanism of an interaction, as well as its coupling strength. Using a method based on dynamical Bayesian inference, we have thus identified and analysed the coupling functions for six relationships. By quantitative assessment of the forms and strengths of the couplings, we have revealed how these relationships are altered by anaesthesia, also showing that some of them are differently affected by propofol and sevoflurane. These findings, together with the novel coupling function analysis, offer a new direction in the assessment of general anaesthesia and neurophysiological interactions, in general.
Collapse
Affiliation(s)
- Tomislav Stankovski
- Department of Physics, Lancaster University, Lancaster LA1 4YB, UK Faculty of Medicine, Ss. Cyril and Methodius University, 50 Divizija 6, Skopje 1000, Macedonia
| | - Spase Petkoski
- Institut de Neurosciences des Systèmes UMR_S 1106, Aix-Marseille Université, Marseille 13005, France
| | - Johan Raeder
- Department of Anaesthesiology, Oslo University Hospital, Oslo 0424, Norway
| | - Andrew F Smith
- Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster LA1 4RP, UK
| | | | | |
Collapse
|
16
|
Wujtewicz MA, Hasak L, Twardowski P, Zabul E, Owczuk R. Evaluation of the relationship between baseline autonomic tone and the vagotonic effect of a bolus dose of remifentanil. Anaesthesia 2016; 71:823-8. [PMID: 27150915 DOI: 10.1111/anae.13505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 12/01/2022]
Abstract
Remifentanil stimulates the parasympathetic nervous system, and patients with increased parasympathetic tone may be at greater risk of bradycardia after its administration. We aimed to establish if adult patients with increased baseline parasympathetic tone were at higher risk of bradycardia and hypotension when given a bolus dose of remifentanil. Seventy adults (age 20-60 years and ASA physical status 1 or 2) were given remifentanil 1 μg.kg(-1) . A Holter ECG monitor was used to assess heart rate changes. Heart rate variability in the frequency domain during the 5 min after remifentanil administration was analysed. Multivariate analysis demonstrated that baseline heart rate was the only independent predictor of remifentanil-induced bradycardia [odds ratio (95% CI) 0.877 (0.796-0.966)]. The vagotonic action of remifentanil does not appear to be related to baseline autonomic tone in adult patients.
Collapse
Affiliation(s)
- M A Wujtewicz
- Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland
| | - L Hasak
- Department of Cardiac Anaesthesiology, Medical University of Gdansk, Gdansk, Poland
| | - P Twardowski
- Department of Anaesthesiology and Intensive Care, Medical University of Gdansk, Gdansk, Poland
| | - E Zabul
- Swissmed Vascular Hospital, Gdansk, Poland
| | - R Owczuk
- Department of Anaesthesiology and Intensive Care, Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
17
|
Kurata J. Mining the hidden dysrhythmia - can machines get smarter at defining the anaesthetised state? Anaesthesia 2015; 70:1338-41. [PMID: 26558853 DOI: 10.1111/anae.13314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Kurata
- Tokyo Medical and Dental University Hospital of Medicine, Bunkyo City, Tokyo, Japan.
| |
Collapse
|