Influence of different concentration of ropivacaine on heart rate variability following intersalene brachial plexus block
- VernacularTitle:不同浓度罗哌卡因肌间沟臂丛神经阻滞对心率变异性的影响
- Author:
Tao LIU
;
Haorong FENG
;
Qunying ZHANG
;
Xianghe WANG
- Publication Type:Journal Article
- Keywords:
Interscalene;
Brachial plexus;
Heart rate variability;
Stellate ganglion;
Hypo-tension;
Bradycardia
- From:
The Journal of Clinical Anesthesiology
2016;32(9):853-856
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of ropivacaine with isodosage on heart rate variability (HRV ) following interscalene brachial plexus block under ultrasound guidance. Methods Forty-five ASA grade Ⅰ patients (28 males,1 7 females,aged 18-50 years)scheduled for upper limb fracture internal fixation removal were randomized into group R1 (0.375% ropivacaine 40ml),group R2(0.5% ropivacaine 30ml)and group R3 (0.75% ropivacaine 20 ml),1 5 in each group.Changes in HRV,such as LF,HF,LF/HF,SDNN,RMSSD,PNN50% were evaluated with dynamic electrocardiogram.The degree and duration of sensory and motor block were recorded 30 min after drug injection.Results The anesthetic effect and maintaining time had no significant difference among the groups.The incidence rate of Horner syndrome had no significant difference among groups,group R1 was 26.7%,group R2 20% and group R3 20%.LF(30 min after drug injection)in both group R2 and group R3 were significantly decreased compared with that before drug injection, and the decreased degree of LF had significant difference among the three groups.SDNN(30 min after drug injection)in group R2 and PNN50% in group R3 were significantly decreased compared with that before drug injection.The time required for LF,the most obvious changeable HRV parameter, returning to the pre injection level was (876.2 +43.7)min for group R1,(798.8 + 61.5 )min for group R2, group R3 (712.2 + 45.7 ) min, the difference between the three groups was not statistically significant.Conclusion ISBPB can affect the stability of the cardiovascular autonomic ac-tivities by reducing the cardiac sympathetic nerve function and increasing parasympathetic nerve func-tion,possibly through blockade of stellate ganglion or branches of vagus nerve.Along with the in-crease of the dose of anesthetic,the influence on HRV is greater.
