Autonomic cardiac regulation after general anesthesia in children
| Autor: | Théa Venet, Hugues Patural, Vincent Pichot, David Charier, Aurélien Scalabre |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.drug_class Anesthetics General Anesthesia General 030204 cardiovascular system & hematology Baroreflex Autonomic Nervous System Hypnotic Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate 030202 anesthesiology Autonomic nervous function medicine Humans Heart rate variability Prospective Studies Child business.industry Infant Heart Sympathetic activity University hospital Autonomic nervous system Anesthesiology and Pain Medicine Child Preschool Anesthesia Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Pediatric Anesthesia. 28:881-887 |
| ISSN: | 1155-5645 |
| DOI: | 10.1111/pan.13468 |
| Popis: | BACKGROUND General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. AIM The aim of this study was to follow the variations in autonomic cardiac indices in children younger than 8 years old after general anesthesia (6-24 hours) in programmed surgery. METHOD A prospective descriptive monocentric study of 44 children under 8 years old who underwent scheduled surgery at our hospital center (Saint-Etienne University Hospital, France) was performed between June 1, 2016 and November 1, 2016. Heart rate variability was monitored for 24 hours using Holter-ECG devices and the resulting data were interpreted using linear and nonlinear analyses. RESULTS Compared to baseline thresholds before surgery, all heart rate variability indices decreased dramatically during general anesthesia. After awakening, a slight reduction in sympathetic activity persisted 6 hours after surgery, but all measurements of sympathetic and parasympathetic activity had returned to baseline thresholds 12 hours after the operation. Twenty-four hours after surgery, some parameters had increased above the corresponding baseline levels. CONCLUSION Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long-term risk of autonomic dysfunction in these patients. |
| Databáze: | OpenAIRE |
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