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Korean Journal of Anesthesiology 2007;53(5):571-576.
DOI: https://doi.org/10.4097/kjae.2007.53.5.571   
The Effect of Sevoflurane Anesthesia on the Phase Relationship between Systolic Blood Pressure and Heart Rate.
Young Kug Kim, Su Jin Kang, Seung Hye Sung, Jae Moon Choi, Ji Hyun Chin, Gyu Sam Hwang
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kyk@amc.seoul.kr
Abstract
BACKGROUND
The phase relationship indicates the time delay between the input signal (systolic blood pressure, SBP) and output signal (R-R interval, RRI). In contrast to the awake state, little is known about the effects of general anesthesia on the phase shift. In the present study, we tested the hypothesis that sevoflurane anesthesia causes a phase change between the two signals.
METHODS
We assessed changes in phase, coherence, and baroreflex sensitivity between SBP and RRI by the use of transfer function analysis in 50 ASA 1 patients during the awake state and during end-tidal 2% sevoflurane-50% N2O anesthesia.
RESULTS
SBP and RRI decreased significantly during sevoflurane anesthesia (P < 0.001). The phase in the low frequency (LF) region remained unchanged, but the phase in the high frequency (HF) region changed significantly from -29.52 +/- 50.70 to 27.28 +/- 80.22 degrees during sevoflurane anesthesia (P < 0.001). Coherence and baroreflex sensitivity between the two signals in the LF and HF regions decreased significantly during sevoflurane anesthesia (P < 0.001, respectively).
CONCLUSIONS
We found that in the HF region and not in the LF region, sevoflurane anesthesia provokes the shift of the SBP-RRI phase relationship, suggesting that this change is inconsistent with a vagally mediated response.
Key Words: coherence; phase; sevoflurane anesthesia


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