Biphasic changes in autonomic nervous activity during pregnancy.

Abstract:

:To understand the sequential response of the autonomic nervous system to pregnancy, we studied heart rate variability in 23 first trimester, 23 second trimester and 21 third trimester pregnant women. Twenty non-pregnant women were recruited as controls. Time and frequency domain measures of heart rate variability in three recumbent positions were compared. We found that normalized high-frequency power in the supine position increased significantly in the first trimester (42.2 (95% confidence interval (CI) 5.4) nu (normalized unit); P < 0.05) compared with non-pregnant controls (33.0 (6.0) nu), and then decreased progressively in the second (27.3 (6.7) nu) and third (21.8 (6.0) nu; P < 0.05) trimesters. The low-/high-frequency power ratio in the supine position decreased significantly in the first trimester (0.8 (0.3); P < 0.05) compared with that of non-pregnant controls (1.1 (0.3)) and increased progressively in the second (1.5 (0.4)) and third (2.1 (0.8); P < 0.05) trimesters. When the position was changed from the supine to the right lateral decubitus, the percentage change in normalized high-frequency power correlated significantly and negatively with normalized high-frequency power in the supine position in non-pregnant controls (r = -0.56, P = 0.01) and in pregnant women in the first (r = -0.44, P = 0.034), second (r = -0.68, P < 0.001) and third (r = -0.68, P < 0.001) trimesters. These results indicate that autonomic nervous activity shifted towards a lower sympathetic and higher vagal modulation in the first trimester, and changed towards a higher sympathetic and lower vagal modulation in the third trimester as gestational age increased. The balance between the haemodynamic changes of pregnancy and aortocaval compression caused by the enlarging gravid uterus may be responsible for the biphasic changes in autonomic nervous activity during pregnancy.

journal_name

Br J Anaesth

authors

Kuo CD,Chen GY,Yang MJ,Lo HM,Tsai YS

doi

10.1093/oxfordjournals.bja.a013433

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

323-9

issue

3

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)38828-1

journal_volume

84

pub_type

杂志文章
  • Pain and the immune system.

    abstract::In inflammation, leucocytes containing opioid peptides migrate into the tissue. Opioid peptides can be released and bind to opioid receptors on peripheral nerve terminals, which counteracts inflammatory pain. Migration of opioid peptide-containing leucocytes is controlled by chemokines and adhesion molecules. Neurokin...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1093/bja/aen078

    authors: Rittner HL,Brack A,Stein C

    更新日期:2008-07-01 00:00:00

  • Determinants of outcome in critically ill octogenarians after surgery: an observational study.

    abstract:BACKGROUND:The population in the UK is growing older and the number of elderly patients cared for on intensive care units (ICU) is increasing. This study was designed to identify risk factors for mortality in critically ill patients of >80 yr of age after surgery. METHODS:We identified 275 patients, aged 80 yr or grea...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aem307

    authors: Ford PN,Thomas I,Cook TM,Whitley E,Peden CJ

    更新日期:2007-12-01 00:00:00

  • Propofol sparing effect of remifentanil using closed-loop anaesthesia.

    abstract:BACKGROUND:General anaesthesia is a balance between hypnosis and analgesia. We investigated whether an increase in remifentanil blood concentration would reduce the amount of propofol required to maintain a comparable level of anaesthesia in 60 patients undergoing ambulatory surgery. METHODS:Patients were allocated ra...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/aeg115

    authors: Milne SE,Kenny GN,Schraag S

    更新日期:2003-05-01 00:00:00

  • Recovery of fibrinogen after administration of fibrinogen concentrate to patients with severe bleeding after cardiopulmonary bypass surgery.

    abstract:BACKGROUND:Normalization of plasma fibrinogen levels may be associated with satisfactory haemostasis and reduced bleeding. The aim of this retrospective study was to assess fibrinogen recovery parameters after administration of fibrinogen concentrate (Haemocomplettan P) to patients with diffuse bleeding in cardiovascul...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aeq058

    authors: Solomon C,Pichlmaier U,Schoechl H,Hagl C,Raymondos K,Scheinichen D,Koppert W,Rahe-Meyer N

    更新日期:2010-05-01 00:00:00

  • Differential effects of neuromuscular blocking agents on suxamethonium-induced fasciculations and myalgia.

    abstract::The effect of pretreatment with suxamethonium, gallamine or pancuronium on suxamethonium-induced fasciculations and myalgia was studied in a controlled, randomized and double-blind clinical trial. Both fasciculations and myalgia were assessed on a four-point rating scale. There was no significant correlation between f...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/60.4.367

    authors: O'Sullivan EP,Williams NE,Calvey TN

    更新日期:1988-03-01 00:00:00

  • Cumulation of neomycin and its residual potentiation of tubocurarine in the cat.

    abstract::Cumulation and interaction of neuromuscular blocking effects of neomycin and tubocurarine were determined on responses of the tibialis anterior muscle of the anaesthetized cat to indirect stimulation. Neuromuscular block produced by neomycin was cumulative despite rapid and apparent full recovery of twitch tension and...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/53.6.571

    authors: Durant NN,Lee C,Katz RL

    更新日期:1981-06-01 00:00:00

  • Comparison of the effects of Org NC 45 and pancuronium bromide on heart rate and arterial pressure in anaesthetized man.

    abstract::The effects of Org NC 45 and pancuronium bromide on heart rate and arterial pressure were studied in anaesthetized man. A bolus of either Org NC 45 0.1 mg kg-1 or pancuronium 0.1 mg kg-1 was administered to lightly anaesthetized unstimulated subjects. Following Org NC 45 heart rate decreased in the majority of subject...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/54.4.435

    authors: Barnes PK,Smith GB,White WD,Tennant R

    更新日期:1982-04-01 00:00:00

  • Monitoring of end-tidal carbon dioxide partial pressure during high frequency jet ventilation.

    abstract::A new method has been developed to measure end-tidal carbon dioxide partial pressure (PECO2) during high frequency jet ventilation (HFJV). A digital flow controller incorporated in a computerized high frequency jet ventilator was used to deliver either a single deep breath or a series of three deep breaths. On user re...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/63.7.47

    authors: Sehati S,Young JD,Sykes MK,McLeod CN

    更新日期:1989-01-01 00:00:00

  • Desflurane-induced post-conditioning against myocardial infarction is mediated by calcium-activated potassium channels: role of the mitochondrial permeability transition pore.

    abstract:BACKGROUND:Desflurane (DES)-induced preconditioning is mediated by large-conductance calcium-activated potassium channels (BK(Ca)). Whether BK(Ca) are involved in anaesthetic-induced post-conditioning is unknown. We tested the hypothesis that DES-induced post-conditioning is mediated by BK(Ca) upstream of the mitochond...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aer496

    authors: Stumpner J,Lange M,Beck A,Smul TM,Lotz CA,Kehl F,Roewer N,Redel A

    更新日期:2012-04-01 00:00:00

  • Neostigmine with glycopyrrolate does not increase the incidence or severity of postoperative nausea and vomiting in outpatients undergoing gynaecological laparoscopy.

    abstract::We studied 100 healthy women undergoing outpatient gynaecological laparoscopy in a randomized, double-blind and placebo-controlled study to evaluate the effect of neostigmine on postoperative nausea and vomiting (PONV). After induction of anaesthesia with propofol, anaesthesia was maintained with sevoflurane and 66% n...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/81.5.757

    authors: Nelskylä K,Yli-Hankala A,Soikkeli A,Korttila K

    更新日期:1998-11-01 00:00:00

  • Nitrous oxide and wound healing.

    abstract::Following a paravertebral surgical incision, mature, female rats under ether anaesthesia were exposed to either 3% nitrous oxide, continuously for 48 h, or 50% nitrous oxide, 4 h each day for 7 days. For each exposure group, a similar number of rats was exposed to atmospheres containing no nitrous oxide. Wound healing...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/57.6.621

    authors: Algie TA,Seth A,Barbenel JC,Galloway DJ,Gray WM,Spence AA

    更新日期:1985-06-01 00:00:00

  • Influence of the site of measurement on the ability of plethysmographic variability index to predict fluid responsiveness.

    abstract:BACKGROUND:Plethysmographic variability index (PVI) is an accurate predictor of fluid responsiveness in mechanically ventilated patients. However, the site of measurement of the plethysmographic waveform impacts its morphology and its respiratory variation. The goal of this study was to investigate the ability of PVI t...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aer165

    authors: Desgranges FP,Desebbe O,Ghazouani A,Gilbert K,Keller G,Chiari P,Robin J,Bastien O,Lehot JJ,Cannesson M

    更新日期:2011-09-01 00:00:00

  • Isoflurane induces endoplasmic reticulum stress and caspase activation through ryanodine receptors.

    abstract:BACKGROUND:Isoflurane has been reported to induce caspase-3 activation, which may induce neurotoxicity and contribute to the pathogenesis of Alzheimer's disease. However, the underlying mechanism is largely unknown, especially whether or not isoflurane can induce ryanodine receptors (RyRs)-associated endoplasmic reticu...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aeu053

    authors: Wang H,Dong Y,Zhang J,Xu Z,Wang G,Swain CA,Zhang Y,Xie Z

    更新日期:2014-10-01 00:00:00

  • Skin conductance monitoring compared with Bispectral Index to assess emergence from total i.v. anaesthesia using propofol and remifentanil.

    abstract:BACKGROUND:Arousal after sevoflurane anaesthesia has been detectable by monitoring changes in skin conductance (SC) with similar accuracy as monitoring Bispectral Index (BIS). As SC monitoring detects changes in sympathetic tone, the measurements might be confounded by the sympatholytic properties of propofol, a compon...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/ael278

    authors: Ledowski T,Bromilow J,Paech MJ,Storm H,Hacking R,Schug SA

    更新日期:2006-12-01 00:00:00

  • Effect of diltiazem and dantrolene on the contractility of isolated malignant hyperpyrexia-susceptible porcine skeletal muscle.

    abstract::Diltiazem inhibited and antagonized the abnormal contractures induced by halothane, caffeine and potassium chloride in isolated skeletal muscle from pigs susceptible to malignant hyperpyrexia (MHS). Contractile responses to caffeine and electrical stimulation also were suppressed by diltiazem in control tissue. Simila...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/62.5.566

    authors: Foster PS,Denborough MA

    更新日期:1989-05-01 00:00:00

  • Capsaicin 8% patch for treprostinil subcutaneous infusion site pain in pulmonary hypertension patients.

    abstract:BACKGROUND:Treprostinil sodium improves haemodynamics and symptoms in pulmonary arterial hypertension (PAH) patients, but its subcutaneous (s.c.) administration can produce severe local site pain, and lead to discontinuation of vital treatment. Treprostinil is a prostacyclin analogue which stimulates prostacyclin recep...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/aet308

    authors: Libri V,Gibbs JS,Pinato DJ,Iddamalgoda T,Khengar RH,Gin-Sing W,Huson L,Anand P

    更新日期:2014-02-01 00:00:00

  • Transilluminated tracheal intubation.

    abstract::We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx. ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/62.5.494

    authors: Ainsworth QP,Howells TH

    更新日期:1989-05-01 00:00:00

  • Right upper lobectomy in a patient with an iatrogenic tracheo-oesophageal fistula after laryngectomy.

    abstract::A patient with a tracheostomy and an iatrogenic tracheo-oesophageal fistula presented for diagnostic bronchoscopy and right upper lobectomy. The anaesthetic management is discussed with reference to the options available and, in particular, the use of a Brompton Pallister single lumen endobronchial tube. ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/74.4.461

    authors: Buchanan CC,Vaughan RS,Verdi I

    更新日期:1995-04-01 00:00:00

  • Fire and explosion hazards in operating theatres.

    abstract::A high degree of safety from fires and explosions exists in operating theatres in the U.K. and this is reflected in the extremely low number of fatal and non-fatal accidents which occur. This has been achieved by safety precautions which in some respects have been over-careful and overexpensive. Antistatic precautions...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/50.7.659

    authors: Vickers MD

    更新日期:1978-07-01 00:00:00

  • Emergence delirium or pain after anaesthesia--how to distinguish between the two in young children: a retrospective analysis of observational studies.

    abstract:BACKGROUND:Early postoperative negative behaviour in preschool children after general anaesthesia is a common problem. The distinction between emergence delirium (ED) and pain is difficult, but management differs between the two. The aim of the current analysis was to identify individual observational variables that ca...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aev552

    authors: Somaini M,Engelhardt T,Fumagalli R,Ingelmo PM

    更新日期:2016-03-01 00:00:00

  • Spasmolytic effects of prostaglandin E1 on serotonin-induced bronchoconstriction and pulmonary hypertension in dogs.

    abstract::In this study, we simultaneously evaluated the spasmolytic effects of prostaglandin E1 (PGE1) on serotonin-induced bronchoconstriction and pulmonary hypertension. Eleven mongrel dogs (8-12 kg) anaesthetized with pentobarbital were assigned to two groups: saline (n = 4) and PGE1 (n = 7). Bronchoconstriction and pulmona...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/85.3.460

    authors: Hashimoto Y,Hirota K,Yoshioka H,Hashiba E,Kudo T,Ishihara H,Matsuki A

    更新日期:2000-09-01 00:00:00

  • Relationship between severe obesity and depth to the cricothyroid membrane in third-trimester non-labouring parturients: a prospective observational study.

    abstract:BACKGROUND:Severely obese parturients have increased 'cannot intubate, cannot oxygenate' risk during Caesarean section under general anaesthesia. Front-of-neck access (FONA) at the cricothyroid membrane (CTM) is definitive management; however, attempted FONA can fail. Point-of-care ultrasonography may provide useful in...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1016/j.bja.2018.02.010

    authors: Gadd K,Wills K,Harle R,Terblanche N

    更新日期:2018-05-01 00:00:00

  • Large volume N2O uptake alone does not explain the second gas effect of N2O on sevoflurane during constant inspired ventilation.

    abstract:BACKGROUND:The second gas effect (SGE) is considered to be significant only during periods of large volume N(2)O uptake (VN(2)O); however, the SGE of small VN(2)O has not been studied. We hypothesized that the SGE of N(2)O on sevoflurane would become less pronounced when sevoflurane administration is started 60 min aft...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/ael008

    authors: Hendrickx JF,Carette R,Lemmens HJ,De Wolf AM

    更新日期:2006-03-01 00:00:00

  • Microvascular and macrovascular flow are uncoupled in early polymicrobial sepsis.

    abstract:BACKGROUND:Microvascular dysfunction is considered to play an important pathophysiological role in sepsis. We addressed the hypothesis that macrovascular and microvascular flow are uncoupled in early sepsis, using a rodent model with well-characterized haemodynamic and biochemical markers of severity and subsequent mor...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aes093

    authors: Dyson A,Cone S,Singer M,Ackland GL

    更新日期:2012-06-01 00:00:00

  • Alcohol increases the solubility of anaesthetics in the liver.

    abstract::Liver/gas partition coefficients for isoflurane, enflurane, halothane and methoxyflurane increased two-fold in rats killed 16 h after a single injection of 15% ethanol 7 g kg-1. In contrast, blood/gas and brain/gas partition coefficients did not change. Chronic (21 days) ingestion of ethanol increased liver/gas partit...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/58.5.551

    authors: Fassoulaki A,Eger EI 2nd

    更新日期:1986-05-01 00:00:00

  • Comparison of the new emulsion formulation of propofol with methohexitone and thiopentone for induction of anaesthesia in day cases.

    abstract::The new emulsion formulation of di-isopropyl phenol (propofol) was compared with methohexitone and thiopentone for induction of anaesthesia in day cases. Propofol produced significantly smoother induction of anaesthesia, but caused more cardiovascular and respiratory depression. Pain on injection was significantly les...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/57.8.725

    authors: Mackenzie N,Grant IS

    更新日期:1985-08-01 00:00:00

  • Bronchial blockers under pressure: in vitro model and ex vivo model.

    abstract:BACKGROUND:Pressures (Pe) exerted by bronchial blockers on the inner wall of the bronchi may cause mucosal ischaemia. Our aims were as follows: (i) to compare the intracuff pressure (Pi) and Pe exerted by commercially available bronchial blockers in an in vitro and an ex vivo model; (ii) to investigate the influence of...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aew120

    authors: Carassiti M,Mattei A,Pizzo CM,Vallone N,Saccomandi P,Schena E

    更新日期:2016-09-01 00:00:00

  • Inhalation induction with sevoflurane: a double-blind comparison with propofol.

    abstract::We conducted a randomized, double-blind comparison of 8% sevoflurane and propofol as induction agents for day-case cystoscopy in 102 patients. All patients received an i.v. cannula and breathed oxygen 5 litre min-1. Anaesthesia was induced with propofol i.v. or inhalation of 8% sevoflurane and 10% Intralipid (as a pla...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/78.4.356

    authors: Thwaites A,Edmends S,Smith I

    更新日期:1997-04-01 00:00:00

  • The entrapped central venous catheter.

    abstract::The central venous catheter (CVC) is associated with numerous complications more so during the process of insertion. We report for the first time how an indwelling catheter was entrapped by a replacement catheter on the same side, after being speared by the introducer needle and guidewire. The diagnosis was made when ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/ael286

    authors: Dhanani J,Senthuran S,Olivotto R,Boots RJ,Lipman J

    更新日期:2007-01-01 00:00:00

  • Effect of timing of ketorolac administration on patient-controlled opioid use.

    abstract::In order to investigate the analgesic effect of timing of administration of ketorolac 10 mg i.v., we recorded patient-controlled use of diamorphine at 2, 4 and 12 h after abdominal hysterectomy. In a randomized, double-blind trial, 30 patients received ketorolac before skin incision and 28 after skin closure. A contro...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/75.1.15

    authors: Rogers JE,Fleming BG,Macintosh KC,Johnston B,Morgan-Hughes JO

    更新日期:1995-07-01 00:00:00