The discriminatory value of cardiorespiratory interactions in distinguishing awake from anaesthetised states: a randomised observational study

Anaesthesia
D KenwrightA Stefanovska

Abstract

Depth of anaesthesia monitors usually analyse cerebral function with or without other physiological signals; non-invasive monitoring of the measured cardiorespiratory signals alone would offer a simple, practical alternative. We aimed to investigate whether such signals, analysed with novel, non-linear dynamic methods, would distinguish between the awake and anaesthetised states. We recorded ECG, respiration, skin temperature, pulse and skin conductivity before and during general anaesthesia in 27 subjects in good cardiovascular health, randomly allocated to receive propofol or sevoflurane. Mean values, variability and dynamic interactions were determined. Respiratory rate (p = 0.0002), skin conductivity (p = 0.03) and skin temperature (p = 0.00006) changed with sevoflurane, and skin temperature (p = 0.0005) with propofol. Pulse transit time increased by 17% with sevoflurane (p = 0.02) and 11% with propofol (p = 0.007). Sevoflurane reduced the wavelet energy of heart (p = 0.0004) and respiratory (p = 0.02) rate variability at all frequencies, whereas propofol decreased only the heart rate variability below 0.021 Hz (p < 0.05). The phase coherence was reduced by both agents at frequencies below 0.145 Hz (p < 0.05), whereas the c...Continue Reading

References

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Citations

Apr 6, 2016·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Tomislav StankovskiAneta Stefanovska
Jun 15, 2016·Anaesthesia·S W Choi, G T C Wong
Apr 18, 2018·Physiological Measurement·Çağdaş TopçuArkady Pikovsky
Feb 2, 2018·Science Advances·Joshua Krissansen-TottonDavid C Catling
Mar 7, 2017·Physiological Measurement·Karsten BergNiels Wessel

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