Premium
Assessment of autonomic nervous activity during gastrointestinal endoscopy: Analysis of blood pressure variability by tonometry
Author(s) -
SAIJYO TETSUYA,
NOMURA MASAHIRO,
NAKAYA YUTAKA,
SAITO KEN,
KONDO YUKI,
YUKINAKA MICHIKO,
SHIMIZU ICHIRO,
ITO SUSUMU
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00738.x
Subject(s) - medicine , premedication , blood pressure , endoscopy , autonomic nervous system , anesthesia , cardiology , heart rate
We continuously measured blood pressure by tonometry in 30 patients during endoscopy to determine the influence of upper gastrointestinal endoscopy on cardiac events. Patients were divided into two groups: one group treated with scopolamine butylbromide as premedication (SB group) and another group without premedication (C group). Time‐ and frequency domain analyses of beat‐to‐beat systolic blood pressure variability were performed for 128 consecutive beats. For time‐domain analysis, we calculated the coefficient of variation of systolic blood pressure (CV BP ). For the frequency domain analysis, we determined the low‐frequency (LF BP ; 0.04–0.15 Hz) and high‐frequency (HF BP ; 0.15–0.40 Hz) powers of the variation in systolic blood pressure and the ratio of LF BP to HF BP (LF BP /HF BP ) during endoscopy. The CV BP and HF BP , indicators of parasympathetic tone, increased in the early phase of endoscopy but decreased significantly in the middle and late phases compared with the pre‐endoscopy value. The ratio of LF BP /HF BP , an indicator of indirect sympathetic tone, increased throughout the endoscopic procedure. Moreover, premedication with scopolamine butylbromide prevents the excessive parasympathetic nervous reflex when an endoscope passes through the upper digestive tract and also brings both decreased parasympathetic tone and increased sympathetic tone at the late phase of endoscopic procedure. Our results indicate that gastrointestinal endoscopy induced an autonomic nervous abnormality, which may contribute to the occurrence of cardiac events during endoscopic procedures.