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Clinical Autonomic Research
Published in: Clinical Autonomic Research 5/2015

01-10-2015 | Research Article

Changes in heart rate variability after sitting following interscalene block

Authors: Jong Hae Kim, Seok Young Song, TaeHa Ryu, Chang Hyuk Choi, Shin Yeung Sung, Woon Seok Roh

Published in: Clinical Autonomic Research | Issue 5/2015

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Abstract

Purpose

Hypotensive bradycardic events (HBEs) occur in 5–28 % of patients undergoing arthroscopic shoulder surgery in the sitting position after an interscalene brachial plexus block (ISBPB). The objective of this study was to investigate the effects of the sitting position following ISBPB on heart rate variability (HRV).

Methods

In this prospective case–control study, we evaluated 64 patients undergoing arthroscopic shoulder surgery under ISBPB and 49 nonsurgical control subjects. HRV power spectral analysis parameters were measured (and natural log-transformed) before ISBPB and after changing to the sitting position. The patients experiencing HBEs were assigned to the HBE group, and the remaining patients were assigned to the non-HBE group.

Results

HBEs developed in 18 patients (28.1 %). Changing from the supine position to the sitting position after ISBPB did not induce a significant increase in the natural log-transformed ratio of low-frequency to high-frequency power (lnLF/HF). A significant decrease in natural log-transformed high-frequency power (lnHF) was observed compared to the control group, who presented a significant increase in lnLF/HF and an insignificant change in lnHF. lnHF was found to be significantly higher in the HBE group compared to the non-HBE group.

Conclusions

Sustained vagal activity with a failed shift in the sympathovagal balance toward sympathetic predominance in response to sitting after ISBPB is associated with the development of HBE.
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Metadata
Title
Changes in heart rate variability after sitting following interscalene block
Authors
Jong Hae Kim
Seok Young Song
TaeHa Ryu
Chang Hyuk Choi
Shin Yeung Sung
Woon Seok Roh
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 5/2015
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0312-z

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