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      KCI등재 SCOPUS SCIE

      당뇨병 환자에서 Rocuronium이 심박수 변이도에 미치는 영향 = The effect of rocuronium on heart rate variability in diabetic patients

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      https://www.riss.kr/link?id=A104327922

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      다국어 초록 (Multilingual Abstract)

      Background: Clinically rocuronium, a muscle relaxant, has no significant inhibitory effect on the autonomic nervous system in the healthy population. However, there has been no study done on rocuronium in diabetic patients. Therefore, we used heart rate variability (HRV) as a biomarker to investigate cardiac autonomic function after rocuronium administration to diabetic patients.
      Methods: In 21 diabetic adult patients, heart rate (HR), mean arterial blood pressure (BP), low frequency (LF, 0.04−0.15 Hz) power, high frequency (HF, 0.15−0.4 Hz) power, LF/HF ratio, SD1 and SD2 in the Poincare plot before induction of anesthesia, and immediately before and after rocuronium administration were calculated and compared.
      Results: HR, mean BP, LF, LF/HF ratio and SD2 after rocuronium administration did not differ significantly from the measurements taken before rocuronium administration. HF and SD1 decreased significantly after rocuronium administration (P = 0.022, P = 0.019 respectively). Covariates such as age, gender, weight, duration of diabetes mellitus and hypertension did not alter the effect of rocuronium on the autonomic nervous system.
      Conclusions: Rocuronium produced a significant decrease in parasympathetic activity. Therefore, further study will be needed to determine whether vagal reduction caused by rocuronium could have potential to deteriorate hemodynamics in diabetic patients.
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      Background: Clinically rocuronium, a muscle relaxant, has no significant inhibitory effect on the autonomic nervous system in the healthy population. However, there has been no study done on rocuronium in diabetic patients. Therefore, we used heart...

      Background: Clinically rocuronium, a muscle relaxant, has no significant inhibitory effect on the autonomic nervous system in the healthy population. However, there has been no study done on rocuronium in diabetic patients. Therefore, we used heart rate variability (HRV) as a biomarker to investigate cardiac autonomic function after rocuronium administration to diabetic patients.
      Methods: In 21 diabetic adult patients, heart rate (HR), mean arterial blood pressure (BP), low frequency (LF, 0.04−0.15 Hz) power, high frequency (HF, 0.15−0.4 Hz) power, LF/HF ratio, SD1 and SD2 in the Poincare plot before induction of anesthesia, and immediately before and after rocuronium administration were calculated and compared.
      Results: HR, mean BP, LF, LF/HF ratio and SD2 after rocuronium administration did not differ significantly from the measurements taken before rocuronium administration. HF and SD1 decreased significantly after rocuronium administration (P = 0.022, P = 0.019 respectively). Covariates such as age, gender, weight, duration of diabetes mellitus and hypertension did not alter the effect of rocuronium on the autonomic nervous system.
      Conclusions: Rocuronium produced a significant decrease in parasympathetic activity. Therefore, further study will be needed to determine whether vagal reduction caused by rocuronium could have potential to deteriorate hemodynamics in diabetic patients.

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      참고문헌 (Reference)

      1 황규삼, "전신마취 시 심박수 변이도의 부교감신경계 분석을 위한 Poincare plot의 유용성" 대한마취과학회 49 (49): 765-770, 2005

      2 Wray DW, "Vagal cardiac function and arterial blood pressure stability" 281 : 1870-1880, 2001

      3 American Diabetic Association, "Standards of medical care in diabetes-2007" 30 : 4-41, 2007

      4 Tulppo MP, "Quantitative beat-to-beat analysis of heart rate dynamics during exercise" 271 : 244-252, 1996

      5 Huang CJ, "Pre-operative measurement of heart rate variability predicts hypotension during general anesthesia" 50 : 542-548, 2006

      6 Miller RD, "Miller's Anesthesia. 6th ed" Churchill Livingstone 511-, 2005

      7 Liao D, "Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes: the atherosclerosis risk in communities (ARIC) study" 51 : 3524-3531, 2002

      8 Cho SK, "Low-dose atropine amplifies cardiac vagal modulation and increases dynamic baroreflex function in humans" 118 : 108-115, 2005

      9 Athyros VG, "Long-term effect of converting enzyme inhibition on circadian sympathetic and parasympathetic modulation in patients with diabetic autonomic neuropathy" 53 : 201-209, 1998

      10 Picker O, "Inhalation anaesthetics increase heart rate by decreasing cardiac vagal activity in dogs" 87 : 748-754, 2001

      1 황규삼, "전신마취 시 심박수 변이도의 부교감신경계 분석을 위한 Poincare plot의 유용성" 대한마취과학회 49 (49): 765-770, 2005

      2 Wray DW, "Vagal cardiac function and arterial blood pressure stability" 281 : 1870-1880, 2001

      3 American Diabetic Association, "Standards of medical care in diabetes-2007" 30 : 4-41, 2007

      4 Tulppo MP, "Quantitative beat-to-beat analysis of heart rate dynamics during exercise" 271 : 244-252, 1996

      5 Huang CJ, "Pre-operative measurement of heart rate variability predicts hypotension during general anesthesia" 50 : 542-548, 2006

      6 Miller RD, "Miller's Anesthesia. 6th ed" Churchill Livingstone 511-, 2005

      7 Liao D, "Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes: the atherosclerosis risk in communities (ARIC) study" 51 : 3524-3531, 2002

      8 Cho SK, "Low-dose atropine amplifies cardiac vagal modulation and increases dynamic baroreflex function in humans" 118 : 108-115, 2005

      9 Athyros VG, "Long-term effect of converting enzyme inhibition on circadian sympathetic and parasympathetic modulation in patients with diabetic autonomic neuropathy" 53 : 201-209, 1998

      10 Picker O, "Inhalation anaesthetics increase heart rate by decreasing cardiac vagal activity in dogs" 87 : 748-754, 2001

      11 Ondocin PT, "Influence of angiotensin converting enzyme inhibitor treatment on cardiac autonomic modulation in patients receiving haemodialysis" 11 : 497-501, 2006

      12 Antelmi I, "Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease" 93 : 381-385, 2004

      13 Sobotka PA, "Impaired hypoxic ventilatory drive in diabetic patients with autonomic neuropathy" 62 : 658-663, 1986

      14 Rajendra Acharya U, "Heart rate variability: a review" 44 : 1031-1051, 2006

      15 Jensen-Urstad K, "Heart rate variability in healthy subjects is related to age and gender" 160 : 235-241, 1997

      16 Ramaekers D, "Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective?" 19 : 1334-1341, 1998

      17 Piccirillo G, "Heart rate and blood pressure variability in obese normotensive subjects" 22 : 741-750, 1998

      18 Sato K, "Effects of non-depolarizing neuromuscular blocking agents on norepinephrine release from human atrial tissue obtained during cardiac surgery" 82 : 904-909, 1999

      19 Nagai H, "Effect of non-depolarizing muscle relaxants on autonomic nervous system activity--assessment by heart rate variability analysis" 48 : 1294-1301, 1999

      20 Takahashi N, "Effect of essential hypertension on cardiac autonomic function in type 2 diabetic patients" 38 : 232-237, 2001

      21 Kuo TB, "Effect of aging on gender differences in neural control of heart rate" 277 : 2233-2239, 1999

      22 Kanaya N, "Differential effects of propofol and sevoflurane on heart rate variability" 98 : 34-40, 2003

      23 Vinik AI, "Diabetic cardiovascular autonomic neuropathy" 115 : 387-397, 2007

      24 Vinik AI, "Diabetic autonomic neuropathy" 26 : 1553-1579, 2003

      25 Takase B, "Comparative effects of amlodipine monotherapy and combination therapy with betaxolol on cardiac autonomic nervous activity and health-related quality of life in patients with poorly controlled hypertension" 72 : 764-769, 2008

      26 Maser RE, "Cardiovascular autonomic neuropathy due to diabetes mellitus: clinical manifestations, consequences, and treatment" 90 : 5896-5903, 2005

      27 Esler M, "Age-dependence of noradrenaline kinetics in normal subjects" 60 : 217-219, 1981

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