心率变异性分析在老年临床麻醉中的应用进展

Application progress of heart rate variability analysis in clinical anesthesia of the elderly

心率变异性分析主要是研究逐次心跳周期间的差异变化,包括神经液体因素对心血管系统调节的信息,能够有效判断心血管疾病病情。心率变异性是反映自主神经系统活性和定量评估交感神经与迷走神经张力以及平衡性,从而判断心血管疾病的病情和预后。心率变异性可能是预测心脏性猝死和心律失常事件有价值的指标。心率变异性分析能够运用到其他多种系统中,多通过心率变异性分析对自主神经功能进行评价,能够间接或直接对自主神经平衡失调造成影响。由于老年患者全身性生理功能降低,对于麻醉的耐受性较差,麻醉风险普遍高于青年人群,因此术前增加部分特殊检查全面评估患者病理与生理状态,积极对患者原发病与并存症进行治疗,能够保证患者在最佳状态下接受麻醉,是提升麻醉安全性与成功率的重要环节。近年来心率变异性分析已受到麻醉界的重视,手术刺激、意识丧失、麻醉药物均会影响自主神经功能,心率变异性也会随之改变,在麻醉中心率变异性分析能够及时观察药物作用情况以及麻醉意外的发生。本文主要综述了心率变异性分析在老年临床麻醉中的研究进展与临床应用。

Heart rate variability analysis is mainly to study the difference between successive heartbeat cycles,including the information of neurofluid factors regulating the cardiovascular system,which can effectively judge the condition of cardiovascular disease.Heart rate variability reflects the activity of autonomic nervous system and quantitatively evaluates the tension and balance of cardiac sympathetic nerve and vagus nerve,so as to judge the condition and prognosis of cardiovascular disease.Heart rate variability may be a valuable index for predicting sudden cardiac death and arrhythmia events.Heart rate variability analysis can be applied to many other systems,and the evaluation of autonomic nerve function through heart rate variability analysis can indirectly or directly affect the imbalance of autonomic nerves.Due to the reduced systemic physiological function of elderly patients,the tolerance to anesthesia is poor,and the risk of anesthesia is generally higher than that of young people.Therefore,it is an important link to improve the safety and success rate of anesthesia to add some special examinations before operation,comprehensively evaluate the pathological and physiological status of patients,and actively treat the primary diseases and coexisting diseases of patients.In recent years,heart rate variability analysis has been widely valued by the anesthesia community.Surgical stimulation,loss of consciousness and anesthetic drugs will affect the autonomic nerve function,and heart rate variability will also change.The heart rate variability analysis in anesthesia can timely observe the action of drugs and the occurrence of anesthesia accidents.This paper mainly reviews the research progress and clinical application of heart rate variability analysis in elderly clinical anesthesia.