Approximate Entropy of hypertension: Effect of Anesthesia

정상혈압환자와 고혈압환자의 마취전후의 근사엔트로피의 비교

Background: Recently, measure of heart rate variability and the nonlinear "complexity" of heart rate dynamics have been used as indicators of cardiovascular health. Several investigators have demonstrated that heart rate variability decreased in aging, congestive heart failure and coronary heart disease. Because hypertensive patients showed alternation of cardiovascular homeostasis, we designed this study to evaluate the effect of anesthesia in hypertensive patients with approximate entropy (ApEn). Methods: With informed consent, eighteen normotensive patients and eighteen hypertensive patients were given no premedication. ECG data were collected from 10 minutes before induction to 15 minutes after induction. Collected ECG data were stored into computer binary files. We calculated ApEn from the collected ECG data. Results: Before induction, ApEn of hypertensive patients was significantly lower than normotensive patients(p<0.05). During induction and maintain of anesthesia, there was no difference of ApEn between two groups. During induction and maintain of anesthesia, in normotensive group, ApEn was significantly lower than that of preinduction(p<0.05). And ApEn during maintain of anesthesia was lower than that of induction(p<0.05). During maintain of anesthesia, in hypertensive group, ApEn was significantly lower than that of preinduction(p<0.05). Conclusions: Before induction, ApTn of hypertensive patients is significantly lower than normotensive patients. As anesthesia was deepened, ApEn of two groups were decreased. Because the baroreflex of hypertensive patients is already decreased, decreasing of ApEn of hypertensive patients during anesthesia is less than that of normotnesive patients.