Using Heart Rate Variability to Stratify Risk of Obstetric Patients Undergoing Spinal Anesthesia

• Published in: Anesthesia and analgesia Vol. 99; no. 6; pp. 1818 - 1821
• Main Authors: Chamchad, Dmitri, Arkoosh, Valerie A., Horrow, Jay C., Buxbaum, Jodie L., Izrailtyan, Igor, Nakhamchik, Lev, Hoyer, Dirk, Kresh, J Yasha
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-12-2004; Lippincott
• Subjects: Adult; Anesthesia; Anesthesia, Obstetrical - adverse effects; Anesthesia, Spinal - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Electrocardiography; Female; Heart Rate - physiology; Humans; Hypotension - diagnosis; Hypotension - etiology; Medical sciences; Nonlinear Dynamics; Predictive Value of Tests; Pregnancy; Risk Assessment; Human; Heart rate; Anesthesia; Obstetrics; Variability; Risk factor
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/01.ANE.0000140953.40059.E6

In this study, we evaluated whether point correlation dimension (PD2), a measure of heart rate variability, can predict hypotension accompanying spinal anesthesia for cesarean delivery. After the administration of spinal anesthesia with bupivacaine, hypotension was defined as systolic blood pressure ≤75% of baseline within 20 min of intrathecal injection. Using the median prespinal PD2 (3.90) to form 2 groups, LO and HI, all 11 hypotensive patients were in the LO group, and all 11 patients without hypotension were in the HI group. Baseline heart rate in the LO group was 95 bpm (10.2 sd), versus 81 bpm (9.6 sd) in the HI group. PD2 shows promise as a predictor of hypotension in pregnant women receiving spinal anesthesia.