Effect of penehyclidine hydrochloride on heart rate variability in hysteroscopy

Abstract

In order to evaluate the effect of different doses of penehyclidine hydrochloride (penehyclidine) on heart rate (HR) and HR variability (HRV) in hysteroscopy, 180 patients (American Society of Anesthesiologists grade I-II) were randomized equally to three groups: 0.5 mg penehyclidine and intravenous anesthesia (group I), 1.0 mg penehyclidine and intravenous anesthesia (group II) and saddle anesthesia combined with intravenous anesthesia (control group). HR and HRV, including total power (TP), low-frequency power (LF), high-frequency power (HF) and the LF to HF ratio (LF/HF), were recorded prior and subsequent to the induction of anesthesia (T₀ and T₁, respectively), following the start of surgery (T₂) and following completion of surgery (T₃). HR was lower at T₂ than at T₀ in the control patients, but no differences were observed in groups I and II. The HR at T₂ was increased in group II compared with that in group I. TP in group II was significantly higher compared with that in group I at T₂. At T₁ and at T₂, the LF and HF values were lower in group I than those in the controls. Patients in group II also had higher LF and HF at T₂ than patients in group I. The HF was higher at T₂ than that at T₀ in the controls; however, the HF and LF did not change significantly within groups I and II. No significant differences were observed in the LF/HF ratio among the three groups. At a dose of 0.5 mg, penehyclidine stabilized HRV and did not alter the autonomic nervous modulation of HR. A penehyclidine dose of 1.0 mg may be superior to a dose of 0.5 mg in maintaining HR, but is less effective at balancing sympathetic and parasympathetic activity.

Keywords: heart rate; heart rate variability; hysteroscopy; penehyclidine.

Figure 1.

Changes in HR (bpm) in the three study groups. ^#P<0.05, group II versus group I at T₂; ^ssP<0.01, T₂ versus T₀ within the control group. Ctrl, control group; HR, heart rate; T₀, prior to the initiation of anesthesia; T₁, following the induction of anesthesia; T₂, at the commencement of surgery; T₃, following the completion of surgery.

Figure 2.

Changes in TP, LF and HF (msec²/Hz) in the three study groups. *P<0.05, **P<0.01 and ***P<0.001, versus the control group; ^#P<0.05 and ^##P<0.01, versus group I (all inter-group comparisons were performed at corresponding time-points). ^ssP<0.01, T₂ versus T₀ within the control group. Ctrl, control group; TP, total power; LF, low-frequency power; HF, high-frequency power; T₀, prior to the initiation of anesthesia; T₁, following the induction of anesthesia; T₂, at the commencement of surgery; T₃, following the completion of surgery.

Figure 3.

Changes in the LF/HF in the three study groups. No significant differences were observed. Ctrl, control group; LF/HF, the ratio of low-frequency power to high-frequency power; T₀, prior to the initiation of anesthesia; T₁, following the induction of anesthesia; T₂, at the commencement of surgery; T₃, following the completion of surgery.