[Correlation between intraoperative hemodynamic variability and postoperative arrhythmias in patients with pulmonary...

Multivariate analyses were performed by logistic regression procedure to identify the significant risk factors for postoperative arrhythmias. The 29 variables included in the analyses were as follows: age, sex, hemodynamic variability, preoperative complication (hypertension, myocardial ischemia, and diabetes mellitus et al), surgical staging for lung cancer, anesthetic method, surgical procedure, intraoperative complications (hypoxemia, arrhythmia and myocardial ischemia), and so on. We evaluated intraoperative hemodynamic variability using mean value and coefficient of variation (CV) of heart rate and blood pressure computed from anesthetic records. Supraventricular tachyarrhythmias occurred in 27 (22.3%) of 121 consecutive patients undergoing pulmonary resection. Increases in mean heart rate and CV of heart rate, older patients, intraoperative blood transfusion, and left thoracotomy were associated with arrhythmias (P < 0.05). There was no correlation of arrhythmia with preoperative complications, surgical staging for lung cancer, anesthetic method, or surgical procedure. It is suggested that impairment of cardiac autonomic nervous system function associated with possible injury to the cardiac autonomic nerves during pulmonary resection is one of the risk factors for arrhythmias after thoracotomy.