INVESTIGATING HEMODYNAMIC CHANGES AND HEART RATE VARIABILITY IN DIABETIC PATIENTS DURING ANESTHESIA INDUCTION
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Keywords
Hemodynamic Changes, Heart Rate Variability, Diabetic Patients, Anesthesia Induction
Abstract
Background: The relationship between heart rate variability and diabetes is well established, with studies showing that reduced HRV is a predictor of diabetic autonomic neuropathy and cardiovascular morbidity. Decreased HRV is associated with an increased risk of arrhythmias, myocardial infarction, and overall mortality in diabetic patients.
Methodology: On the day prior to surgery, patients underwent a 10-minute heart rate variability (HRV) assessment, after resting for 10 minutes with their eyes open during the recording. The HRV analysis included both time-domain and frequency-domain parameters: Hemodynamic parameters measurements were taken at several intervals: pre-induction, post-induction, post-intubation, and every 3 minutes for the next 15 minutes.
Results: Diabetic individuals exhibited a higher tendency to develop bradycardia compared to non-diabetics. Additionally, the decrease in heart rate after induction was more pronounced in the diabetic group than in the non-diabetic group. A decrease in MAP was observed in both groups after induction. However, diabetic individuals had a comparatively lower MAP than non-diabetics, particularly after induction and post-intubation. The difference was statistically significant at 12 and 15 minutes post-intubation (p = 0.04).
Conclusion: The findings suggest that preoperative HRV assessments could help predict cardiovascular responses and guide individualized anesthesia strategies. Given the potential risks associated with altered autonomic regulation in this population, tailored perioperative management is essential to ensure better outcomes.
References
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Nimta Kishore
Associate Professor, Department of Anesthesiology, F H Medical College, Firozabad (UP)
Vivek Pushp
Senior Consultant and Head, Department of Anesthesiology, Felix Hospital, Noida (UP)
Anil Kumar Gupta
Associate Professor, Department of Anesthesiology, ASMC, Firozabad (UP)
Devendra Kumar
Associate Professor, Department of Community Medicine, ASMC, Firozabad (UP)