不停跳冠脉搭桥病人心率变异性的变化

目的 探讨不停跳冠脉搭桥病人麻醉和手术过程中自主神经系统功能的变化。方法 选择40例择期不停跳冠脉搭桥病人，采用芬太尼、咪唑安定、哌库溴铵及心血管活性药物等对病人实施麻醉；应用心率变异性(HRV)分析法对该组病例术中不同阶段的心率变异性改变进行分析。结果 麻醉诱导后LF、HF、LF/HF、TP显著降低，气管插管后各阶段除LF/HF外均显著升高，而LF/HF在整个手术过程中无明显变化。结论 不停跳冠脉搭桥手术中，伤害刺激可导致心率变异性升高，而LF/H术中无明显改变，表明本组麻醉中的镇痛成分已满足手术要求。

Changes of heart rate variability in patients undergoing off-pump coronary artery bypass

To analyse the changes of the autonomic nervous system in Off-pump coronary artery bypass (OPCAB) patients. Forty patients without psychosis, memory barrier or dysfunction of the central and autonomic nervous system undergoing OPCAB on certain dates were selected. Anesthesia was induced by midazolam, fentanyl and pipecuronium. Anesthesia was maintained with additional intravenous fentanyl and pipecuronium, as well as continuously pumped propofol, along with appropriate blood vessel active drugs. Heart rate variability(HRV) was assessed before operation, after anesthesia induction, after trachea intubation, sternum split and rebuilding of chest wall using heart rate variability power spectrum analysis (HRV-PSA). Low frequency (LF), high frequency (HF) and total power (TP) decreased significantly after induction except LF/HF (P<0.05). LF/HF did not change markedly and was kept to the end of surgery. [Conclusions] The results indicate that the total power of autonomic nervous system are decreased significantly during anesthesia and operative trauma in OPCAB patients compared with LF/HF which did not changed markedly and was kept to the end of surgery, which indicates that the indolence is enough.