PMID: 15220767Jun 29, 2004Paper

Autonomic nervous system response to epidural analgesia in laboring patients by wavelet transform of heart rate and blood pressure variability

Anesthesiology
Alain DeschampsGilles Plourde

Abstract

Epidurals are effective in relieving labor pain but result in a sympathectomy that may compromise maternal hemodynamic stability and fetal perfusion. Decreases in blood pressure and heart rate can be corrected, but markers of autonomic activity would be useful to predict and prevent such changes. The goal of this study was to find markers describing the changes in autonomic nervous system activity with epidural anesthesia in laboring patients. The authors analyzed heart rate variability and blood pressure variability in 13 laboring patients using wavelet transform, a time-frequency analysis that accommodates rapid changes in autonomic activity. Heart rate and blood pressure variability were obtained 5 min before and 10 min after injection of 20 ml bupivacaine, 0.125%, and 50 microg fentanyl in the epidural space. Blood pressure and heart rate were not affected by epidural analgesia. However, high-frequency power of heart rate variability increased after epidural (increase in parasympathetic drive). The ratio of low-frequency:high-frequency power of heart rate variability decreased. High- and low-frequency power of blood pressure variability decreased (decrease in sympathetic outflow). Indices of parasympathetic and sympathetic ...Continue Reading

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Citations

Apr 2, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Alain Deschamps, André Denault
Mar 3, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Alain DeschampsKaren Loo
Mar 1, 2012·International Journal of Obstetric Anesthesia·M Le GuenM Fischler
Oct 6, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Alain DeschampsBianca D'Antono
Jan 23, 2009·International Journal of Obstetric Anesthesia·A WeissmanA Drugan
Apr 26, 2006·Best Practice & Research. Clinical Anaesthesiology·Bruno Guignard
Dec 9, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Jonathan CohenBassam Haddad
Jul 21, 2009·Seminars in Cardiothoracic and Vascular Anesthesia·Alain Deschamps, André Denault
Jan 14, 2020·The American Journal of Clinical Hypnosis·Julie ExcoffierFlorian Chouchou

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