Autonomic Nervous System Response to Epidural Analgesia in Laboring Patients by Wavelet Transform of Heart Rate and Blood Pressure Variability

2004 ◽  
Vol 101 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Alain Deschamps ◽  
Ian Kaufman ◽  
Steven B. Backman ◽  
Gilles Plourde
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Wavelet Transform ◽  
Autonomic Nervous System ◽  
Blood Pressure Variability ◽  
Autonomic Activity ◽  
Neuraxial Blockade ◽  
Frequency Power

Background Epidurals are effective in relieving labor pain but result in a sympathectomy that may compromise maternal hemodynamic stability and fetal perfusion. Decreases in blood pressure and heart rate can be corrected, but markers of autonomic activity would be useful to predict and prevent such changes. The goal of this study was to find markers describing the changes in autonomic nervous system activity with epidural anesthesia in laboring patients. Methods The authors analyzed heart rate variability and blood pressure variability in 13 laboring patients using wavelet transform, a time-frequency analysis that accommodates rapid changes in autonomic activity. Heart rate and blood pressure variability were obtained 5 min before and 10 min after injection of 20 ml bupivacaine, 0.125%, and 50 microg fentanyl in the epidural space. Results Blood pressure and heart rate were not affected by epidural analgesia. However, high-frequency power of heart rate variability increased after epidural (increase in parasympathetic drive). The ratio of low-frequency:high-frequency power of heart rate variability decreased. High- and low-frequency power of blood pressure variability decreased (decrease in sympathetic outflow). Conclusions Indices of parasympathetic and sympathetic activity after neuraxial blockade in laboring patients can be obtained by analysis of both heart rate variability and blood pressure variability. The analysis by wavelet transform can discern changes in autonomic activity when values of blood pressure and heart rate do not vary significantly. Whether this technique could be used to predict and prevent hemodynamic compromise after neuraxial blockade merits further studies.

19. Role of the autonomic nervous system in blood pressure and heart rate variability in conscious rats

1991 ◽  
Vol 9 (6) ◽  
pp. S429
Author(s):  
C. Cerutti ◽  
M. Lo ◽  
Claude Julien ◽  
Madelaine Vincent ◽  
C. Paultre ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Conscious Rats ◽  
Autonomic Nervous

scholarly journals 0461 Blunted Baroreflex Sensitivity and Reduced Morning Parasympathetic Activity in Sleep-Onset Insomnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A177-A177
Author(s):  
H Tsai ◽  
T Kuo ◽  
C Yang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Events ◽  
Blood Pressure Variability ◽  
Baroreflex Sensitivity ◽  
Sleep Onset ◽  
Low Frequency ◽  
Sleep Structure ◽  
Frequency Power

Abstract Introduction Insomnia is a risk factor for hypertension and cardiovascular events, and this association is strongest for sleep-onset insomnia. However, little is known about insomnia on cardiovascular modulation, especially soon after morning awakening, the peak period of time for cardiovascular incidents. This study explored morning cardiovascular function in individuals with sleep-onset insomnia by analysing heart rate variability, blood pressure variability, and baroreflex sensitivity. Methods Sleep structure of the participants (15 good sleepers and 13 individuals with sleep-onset insomnia) was measured by laboratory polysomnography, followed by continuous recordings of the participant’s blood pressure and heart rate for 10 min in the morning. Results When compared to the good sleepers, the insomnia group showed significant reductions in total sleep time, a longer sleep-onset latency, and reduced sleep efficiency. The sleep structure, including durations of sleep stages, numbers of awakenings and arousal index did not differ between the groups. After morning awakening (averaged time: 12.33 ± 10.48 min), the shorter R-R intervals, lower total power, and lower high-frequency power of heart rate variability were observed among individuals with sleep-onset insomnia, compared with good sleepers. Elevated slopes of systolic and diastolic blood pressure, as well as lower baroreflex sensitivity, were also shown in the insomnia group. Indices of sympathetic activity, including low-frequency percentage of heart rate variability or low-frequency power of blood pressure variability, did not differ between the groups. Conclusion Weak vagal activity and blunted baroreflex sensitivity were evident among sleep-onset insomnia. These findings indicate difficulty in initiating sleep, without significant sleep fragmentation, can independently affect morning cardiovascular function. This study provides a possible link between sleep-onset insomnia and risk of cardiovascular events. Support N/A

scholarly journals Autonomic response of gradient exercise testing protocol in normotensive, overweight, and pre-hypertensive individuals: a prospective, observational, and analytical study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Neha Bala ◽  
Aashish Negi ◽  
Yogesh Saxena ◽  
Sarfaraz Alam
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Diastolic Blood Pressure ◽  
Exercise Testing ◽  
Autonomic Response ◽  
Testing Protocol

Abstract Background Coronary artery disease (CAD) is increasing day by day in young Indian population with increase in risk factors such as obesity, hypertension etc. Although in early age, these risk factors are clinically asymptomatic but physiologically they are symptomatic. These symptoms can be best assessed by assessing the response of autonomic nervous system Therefore the purpose of this study was to compare the autonomic response of gradient exercise testing protocol in normotensive, overweight, and pre-hypertensive subjects in the form of chronotropic response to exercise, inotropic reponse, heart rate recovery, blood pressure recovery, BRPE, and heart rate variability so that the physiological abnormalities can be corrected. Results There were significant differences (p < 0.05) found in gradient exercise testing protocol in diastolic blood pressure in normotensive, in heart rate variability in overweight and in both systolic as well as diastolic blood pressure in pre-hypertensive subjects. Conclusion Gradient exercise testing protocol can be best utilized as a clinical tool in normotensive, overweight, and pre-hypertensive subjects for the assessment of autonomic nervous system which provides diagnostic and prognostic information regarding cardiovascular disease or abnormalities.

Influence of vertebral manipulations on the autonomic nervous system

2021 ◽  
pp. 106-120
Author(s):  
J. M. Sebastian Rausell ◽  
A. B. Martinez Garcia ◽  
A. S. Jaume Llinas ◽  
I. Escobio Prieto
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Spinal Manipulation ◽  
Parasympathetic Nervous System ◽  
Clinical Effectiveness ◽  
Current Evidence ◽  
Autonomic Nervous

Introduction. Although its neurophysiological effects have not been fully elucidated, current evidence suggests the clinical effectiveness of spinal manipulation. Different studies suggest that manual therapy induces changes in the autonomic nervous system (ANS). Recent studies showed that mobilization produced a sympatheticexcitatory effect. However, studies using thrust manipulation appeared to be less consistent in their results.Objectives. The main objective of this review was to evaluate whether spinal manipulation induces effects on the ANS. Another objective was to correlate the changes in the measured variables with the activation or inhibition of the sympathetic or parasympathetic nervous system and with the level of spinal manipulation.Materials and methods. We performed a literature search in the following databases: PubMed, PEDro, CINAHL and OVID, using the keywords «Manipulation, spinal» and «Autonomic Nervous System». The PEDro scale was used to assess the methodological quality.Results. Nine studies met the inclusion criteria. Six trials measured cardiovascular function indicators (blood pressure, heart rate, Heart Rate Variability). Three other trials measured the pupil reaction. In most studies, cervical or upper thoracic region was manipulated.Conclusions. Our review does not provide definitive evidence of the effects of spinal manipulation on the ANS. However, most studies observed the existence of autonomic effects by modifying parameters such as blood pressure or Heart Rate Variability after manipulation. Increased parasympathetic activation probably occurs after cervical and lumbar treatment and increased sympathetic activation after dorsal treatment.

Sign in / Sign up

Export Citation Format

Share Document