The Effects Of Low Epidural Anesthesia On Heart Rate Variability And Circulatory System In Elderly Patients With Hypertension

Objectives:To find out the influence of low epidural anesthesia on elderly patients with hypertension through the observation of HRV, blood pressure and cardiac rate in 60 patients who were adopted routine selective pelvic cavity operation or lower limb operation.Methods:60 patients were divided into three groups,20 cases in every group:treatment group(Group A),untreated group(Group B) and control group(Group C).In treatment group(Group A),patients were confirmed essential Hypertension,long term use of antihypertensive drugs(Nifedipine) over six months and preoperative blood pressure was controlled under 140/90 mmHg over two weeks. In untreated group(Group B),patients were confirmed essential Hypertension,without systematical antihypertensive treatment for more than 6 months in preoperative period,and preoperative blood pressure was above 140/90 mmHg.In control group(Group C), patients were confirmed no Hypertension,preoperative blood pressure below 140/90mmHg.To observe HRV low frequency(LF),high frequency(HF),low frequency and high frequency ratio(LF/HF), systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) at before administration(T₀);after epidural injection 5min(T₁),10min(T₂),15min(T₃),30min(T₄),45min(T₅).Compare the difference of LF,HF,SBP,DBP,HR,and LF/HF in each group.In group comparison,LF,HF,SBP,DBP,HR after anesthesia were significantly lower than pre-anesthesia in each time point(P＜0.05);In inter-group comparison,decreased extent of LF, HF,SBP,DBP of patients with anesthesia in treatment group and non-treatment group was significantly greater than that of the control group in each time point(P＜0.05);the decline and volatility of LF, HF,SBP,DBP,HR,LH/HF of non-treatment group after anesthesia was significantly different than that of group A and group B in each time point.Conclusion:Low epidural anesthesia would exert huge impact to the autonomic nervous system of elderly patients,which caused lower blood pressure,slower heart rate.Blood pressure and heart rate in elderly patients with hypertension were more obvious than that of non-hypertensive patients.Preoperative antihypertensive treatment was helpful to improve the autonomic nervous system regulation of elderly patients with hypertension,so as to maintain its stability of volatility in elderly patients with hypertension during epidural anesthesia.