低位硬膜外麻醉期间老年人心率变异性及循环功能的临床研究

目的观察低位硬膜外麻醉对老年患者心率变异性（HRV）及血压、心率的影响。方法37例接受盆腔或下肢手术者行低位硬膜外麻醉，监测时点：麻醉前（T0）、硬膜外腔注药后5min（T1）、10min（T2）、15min（T3）、30min（T4）、45min（T5）；监测项目：收缩压（SBP）、舒张压（DBP）、心率（HR）、HRV的低频率（LF）、高频率（HF）、低频与高频比率（LF／HF）。结果患者麻醉后各时点的SBP、DBP、LF、HF均较麻醉前降低（P〈0．05）。结论低位硬膜外麻醉对老年患者自主神经系统有一定的影响，使患者出现血压降低、心率减慢。

Clinical study of low epidural anesthesia on heart rate variability and circulatory function in elderly patients

Objective To find out the influence of low epidural anesthesia to elderly patients through the observation of HRV,blood pressure and cardiac rate. Methods Thirty seven patients who were adopted routine selective pelvic cavity operation or lower llmb operation in one groups. Monitoring point ： before administration （T0 ）, after epidural injection 5 minutes （T1 ）, 10 minutes （ T2 ）, 15 minutes （ T3 ）,30 minutes （ T4 ） ,45 minutes （ T5 ）. Monitoring projects ： HRV low frequency （ LF）, high frequency （ HF）, low frequency and high frequency ratio （LF/HF） ,systolic blood pressure （SBP） ,diastolic blood pressure （DSP） ,heart rate （HR）. Compare the difference of LF,HF,SBP,DBP, ttR,and LF/HF in each group. Results In the group,LF,HF, SBP, DBP, HR after anesthesia were lower than pre-anesthesia in each time point. There were significant differences （P 〈 0.05）. Conclusion Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly patients ,which caused them lower blood pressure, slower heart rate.