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Published on: September 18, 2014
Cardiac autonomic regulation during gastroscopy
M Ristikankare1, R Julkunen, M Heikkinen
1Laakso Hospital, City of Helsinki Health Centre, 00099 Helsinki, Finland. matti.ristikankare@kolumbus.fi
Summary
Gastroscopy increases sympathetic cardiac activity. Midazolam sedation significantly amplifies this effect, impacting heart rate variability during the procedure.
Area of Science:
- Cardiology
- Autonomic Nervous System Regulation
- Gastroenterology
Background:
- Gastroscopy procedures are sometimes linked to adverse cardiovascular events.
- Understanding the impact of sedation and anesthesia on cardiac function during gastroscopy is crucial for patient safety.
Purpose of the Study:
- To evaluate the effects of sedation and pharyngeal anesthesia on cardiac autonomic regulation during gastroscopy.
- To compare the impact of midazolam sedation versus lidocaine pharyngeal anesthesia on heart rate variability.
Main Methods:
- A study involving 213 outpatients undergoing gastroscopy.
- Patients were divided into four groups: midazolam sedation, lidocaine anesthesia, placebo, and control.
- Continuous electrocardiogram monitoring and heart rate variability analysis were performed.
Main Results:
- Gastroscopy induced sympathetic nervous system activation and reduced vagal modulation, indicated by changes in heart rate variability components.
- Midazolam sedation significantly potentiated this sympathetic shift compared to lidocaine, placebo, and control groups.
- Overall heart rate variability decreased, particularly in the midazolam group.
Conclusions:
- Gastroscopy shifts cardiac autonomic control towards sympathetic dominance.
- Midazolam premedication exacerbates this sympathetic shift, highlighting potential cardiovascular risks.
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