60세 이상의 고혈압 환자에서 Bispec tral Index에 따른 Propofol 효과처농도, 혈역학적 변화 및 심박수변이도 분석 = Effect-site Concentration of Propofol, Hemodynamic Responses and Heart Rate Variability According to Bispectral Index in Elderly Hypertensive Patients

다국어 초록 (Multilingual Abstract)

Background: We evaluated the changes in effect-site concentration
(Ce) of propofol, hemodynamic responses and heart rate variability
(HRV) in elderly patients with or without hypertension according
to bispectral index (BIS) during target effect-site controlled infusion
(TCEI) of propofol.
Methods: Twenty four elderly patients with (group H, n = 12) or
without hypertension (group C, n = 12) were recruited. We analyzed
the spectral components of HRV at the BIS of 60-80 and 40-60
during TCEI of propofol. We also measured systolic and diastolic
blood pressure (SBP and DBP), mean arterial pressure (MAP), heart
rate (HR) and predicted Ce of propofol.
Results: The predicted Ce in group H (2.76 ± 0.20μg/ml) was
significantly lower than that in group C (3.53 ± 0.24μg/ml) at the
BIS of 60-80. BP in both groups decreased significantly in a
BIS-dependent manner. The low frequency power (LnLF) in group
H decreased significantly to 83.5 ± 4.6% and 79.1 ± 4.4% of
pre-induction value at the BIS of 60-80 and 40-60, respectively.
At the BIS of 60-80, the change of HR in group H was
inversely proportional to the change of total (LnTP) and high
frequency power (LnHF) significantly (P ＜ 0.05).
Conclusions: The group H required significantly lower Ce of propofol
than group C for BIS 60-80. The LnLF in group H decreased
significantly at the BIS of 60-80 and 40-60 compared with pre-induction value. At the BIS value of 60-80, the change of HR
in group H showed inversely proportional correlation with that of LnTP
and LnHF significantly.