Comparison of heart rate variability response in children undergoing elective endotracheal intubation with and without neuromuscular blockade: a randomized controlled trial

摘要: Summary Background The routine use of neuromuscular blocking drugs (NMBD) for endotracheal intubation in children is the subject much controversy. The analysis heart rate variability (HRV) can reveal information about functional state autonomic nervous system (ANS). Aim The purpose this study was to determine if HRV elucidates differences sympathovagal balance undergoing elective endo-tracheal with and without blockade (NMB). Methods In prospective study, 38 (2–6 years) scheduled adenotonsillectomy were randomized into two groups receive fentanyl 2 μg·kg−1 propofol 4 mg·kg−1, either mivacurium 0.25 mg·kg−1 (NMB group) or saline solution (NoNMB anesthesia induction. same experienced, blinded anesthesiologist performed intubation. Heart variability, RR intervals, ECG as well an electroencephalogram recorded BIS XP monitors, respectively. analyzed frequency domain. Results There no significant difference changes immediately after administration compared saline. comparable bispectral index value 35 [33–41] vs NoNMB 34 [32–42]) during Changes both low-frequency power low-/high-frequency ratio unstimulated before laryngoscopy significantly higher NMB (P = 0.015 P = 0.006, respectively), whereas there respect high-frequency power. Conclusions The stress response pediatric patients represented by domain found be NMB. When added a propofol–fent-anyl induction regimen, ANS alterations decreased significantly.