Abstract：
The aim of the proof-of-concept study is to investigate the level of concordance between the heart rate variability (HRV), the EEG-based Narcotrend Index as a surrogate marker for the depth of hypnosis, and the minimal alveolar concentration (MAC) of the inhalation anesthetic sevoflurane across the entire course of a surgical procedure. This non-blinded cross-sectional study recorded intraoperative HRV, Narcotrend Index, and MAC in 31 male patients during radical prostatectomy using the Da-Vinci robotic-assisted surgical system at Mannheim University Medical Center. The degree of concordance was calculated using repeated measures correlation with the R package (rmcorr) and presented using the rmcorr coefficient (rrm). The Narcotrend Index correlates significantly across all measures with the time-dependent parameter of HRV, the standard deviation of the means of RR intervals (SDNN) (rrm = 0.2; p < 0.001), the frequency-dependent parameters low frequency (LF) (rrm = 0.09; p = 0.04) and the low frequency/high frequency ratio (LF/HF ratio) (rrm = 0.11; p = 0.002). MAC correlated significantly negatively with the time-dependent parameter of heart rate variability, SDNN (rrm = -0.28; p < 0.001), the frequency-dependent parameter LF (rrm = -0.06; p < 0.001) and the LF/HF ratio (rrm = -0.18; p < 0.001) and the Narcotrend Index (rrm = -0.49; p < 0.001) across all measures. HRV mirrors the trend of the Narcotrend Index used to monitor depth of hypnosis and the inhibitory influence of the anesthetic sevoflurane on the autonomic nervous system. Therefore, HRV can provide essential information about the homeostasis of the autonomic nervous system during general anesthesia. DRKS00024696, March 9th, 2021.
摘要：
概念验证研究的目的是调查心率变异性（HRV）之间的一致性水平，基于EEG的Narcotrend指数作为催眠深度的替代标记，以及整个外科手术过程中吸入麻醉剂七氟醚的最低肺泡浓度（MAC）。这项非盲横断面研究记录了术中HRV，Narcotrend指数，曼海姆大学医学中心使用达芬奇机器人辅助手术系统进行根治性前列腺切除术的31名男性患者的MAC。使用与R包相关的重复测量（rmcorr）计算一致性程度，并使用rmcorr系数（rrm）表示。Narcotrend指数在所有测量中与HRV的时间依赖性参数显着相关，RR间隔均值的标准偏差(SDNN)(rrm=0.2；p<0.001)，频率相关参数低频（LF）（rrm=0.09；p=0.04）和低频/高频比（LF/HF比）（rrm=0.11；p=0.002）。MAC与心率变异性的时间依赖性参数显着负相关，SDNN(rrm=-0.28；p<0.001)，所有测量值的频率相关参数LF(rrm=-0.06;p<0.001)和LF/HF比率(rrm=-0.18;p<0.001)和Narcotrend指数(rrm=-0.49;p<0.001)。HRV反映了用于监测催眠深度的Narcotrend指数的趋势以及麻醉剂七氟醚对自主神经系统的抑制作用。因此,HRV可以提供有关全身麻醉期间自主神经系统稳态的基本信息。DRKS00024696，3月9日，2021年。
