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Published on: November 19, 2015
Respiratory sinus arrhythmia and clinical signs of anaesthesia in children
1Department of Anaesthesia, University of Manchester, Manchester Royal Infirmary.
Insights
Respiratory sinus arrhythmia (RSA) significantly decreases during anesthesia induction in children. This change correlates with clinical signs, suggesting RSA
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Autonomic Nervous System Function
Background:
- Assessing anesthetic depth in children is crucial for patient safety.
- Respiratory sinus arrhythmia (RSA) reflects autonomic nervous system activity.
- Changes in RSA during anesthesia induction require further investigation in pediatric patients.
Purpose of the Study:
- To investigate changes in respiratory sinus arrhythmia (RSA) during gaseous anesthesia induction in children.
- To compare RSA variations with established clinical signs of anesthetic depth.
- To evaluate the potential of RSA as a quantitative measure for anesthetic depth in pediatric patients.
Main Methods:
- Pediatric patients aged 3-10 years underwent gaseous induction using halothane and nitrous oxide.
- Heart rate variability (HRV) spectra were analyzed using power spectral analysis.
- RSA was quantified by integrating spectral curve areas around the respiratory frequency.
Main Results:
- RSA demonstrated a continuous decrease throughout anesthesia induction in all patients.
- Significant decreases in RSA were observed from baseline to loss of pharyngeal tone (P = 0.003) and to stage 3 (P = 0.018).
- Stimulation, such as airway insertion, temporarily altered the decreasing trend of RSA.
Conclusions:
- RSA levels correlate significantly with clinical indicators of anesthetic depth in children.
- The observed decrease in RSA during induction suggests its utility in monitoring anesthetic depth.
- RSA holds potential as a non-invasive, objective measure for assessing anesthetic depth in pediatric patients.
Abstract:
We have investigated changes in respiratory sinus arrhythmia (RSA) and compared these with clinical signs of anaesthesia in children. Children aged 3-10 yr were anaesthetized by gaseous induction with halothane and nitrous oxide. Multiple heart rate variability (HRV) spectra were obtained by power spectral analysis of continuous epochs of time from before introduction of halothane (baseline) until the pupils were central and fixed (stage 3). Measurement of RSA was performed by integration of the area under the spectral curve within the range of the respiratory frequency +/- 0.15 Hz. In all patients RSA decreased continuously during induction unless stimulation occurred with insertion of an airway. Values of RSA were compared at three times: baseline, loss of pharyngeal tone and stage 3. The decrease in RSA from baseline to loss of pharyngeal tone and from loss of pharyngeal tone to stage 3 was significant (P = 0.003 and P = 0.018, respectively). These results show that RSA can be related to the clinical signs of anaesthesia and has potential as a measure of depth of anaesthesia in children.
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