Comparison of Invasive and Non-invasive Measurement of Spontaneous Baroreflex during Anesthesia

麻醉中使用侵犯性及非侵犯性動脈壓訊號測量在自主感壓反射分析之比較

黃謙琳(Chien-Lin Huang) ； 劉健強(Chien-Chian Liu) ； 曾祥建(Hsiang-Chien Tseng) ； 王永彬(Yong-Ping wang) ； 蔡勝國(Shen-Kuo Tsai)

《Acta Anaesthesiologica Sinica》 38卷3期 (2000/09) Pp. 149-153

https://doi.org/10.6955/AAS.200009.0149

摘要

背景：動脈壓訊號和心跳R-R interval之分析可用作觀測感壓反射強度指標，并進一步窺探病人自主神經系統之狀況。本實驗目的在評估非侵犯性動脈壓訊號測量用於麻醉中自主感壓反射分析之可行性。
方法：記錄30位麻醉體位評議為壹有級且接受常規肝癌或胃癌手術的病人之動脈壓訊號和心跳R-R interval，利用序列分析(sequence analysis)計算自主感壓訊號反射敏感度(spontaneous baroreflex sensitivity, SBR)，比較使用侵犯性及非侵犯性動脈壓訊號測量方法所得到之SBR值之差异。
結果：利用侵犯性及非侵犯性動脈壓訊號之測量方法，不論兩者測量值是取自同側手或對側手，所取得之SBR值有顯著相關(r=0.96)，平均差异(mean difference)為0.22 ms/mmHg而個別資料差异為-0.52到＋0.96 ms/mmHg(-35% to +60%)。
結論：雖然個別資料差异大，非侵犯性動脈壓訊號測量法提供極相似於侵犯性動脈壓測量法之結果，建議非侵犯性動脈壓測量法可作為感壓反射分析時另一植測量工具，因此更容易取得邊續血壓值，進而更方便瞭解病人自主神經系統之狀況。

關鍵字

自主神經系統 ； 感壓反射 ； 血壓測量：Finapres

並列摘要

Background: Many works have shown that beat-to-beat variations in systolic arterial pressure (SAP) could be used for the assessment of cardiac baroreflex function. The purpose of this study was to evaluate whether Finapres, a non-invasive device to measure systolic arterial pressure, could serve as an acceptable alternative to intra-arterial catheterization for assessing the spontaneous baroreflex during anesthesia.
Methods: Thirty ASA class I patients scheduled for surgical hepatic and gastric tumor excisions were enrolled in this study. Spontaneous baroreflex sensitivity (SBR) during anesthesia was calculated by sequence analysis of beat-to-beat variations in systolic arterial pressure and R-R intervals. Data obtained from Finapres were compared with those from standard intra-arterial catheterization technique.
Results: SBR values determined by non-invasive and invasive blood pressure measurement technique were precisely correlated (r = 0.96) and the mean difference was about 0.22 ms/mmHg (12.5%). Howevet; the individual data might differ by -0.52 to + 0.96 ms/mmHg (-35% to + 60%).
Conclusions: Finapres may trace the changes of SBR during anesthesia and provides similar results as does invasive method but individual variation exists.

並列關鍵字

Autonomic nervous system ； Baroreflex ； Blood pressure monitoring: Finapres