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Erschienen in: Journal of Clinical Monitoring and Computing 6/2020

01.12.2020 | Original Research

Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers

verfasst von: Chun-Ning Ho, Pei-Han Fu, Jen-Yin Chen, Kuo-Chuan Hung, Jia-Hui Chang, Chung-Kang Peng, Albert C. Yang

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 6/2020

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Abstract

Poor sleep quality is associated with autonomic dysfunctions and altered pain perception and tolerance. To investigate whether autonomic dysregulations related to insomnia would still exist under general anesthesia, we adopt heart rate variability (HRV) analysis to evaluate ANS activity and surgical pleth index (SPI) to compare nociceptive/anti-nociceptive balance. We enrolled 61 adult females scheduled for gynecological surgeries under general anesthesia. All the subjects were ASA Class I to III without using medicines affecting HRV. We used the Insomnia Severity Index to evaluate sleep qualities. ECG data were recorded and signals which denote four different surgical stages were extracted (baseline, incision, mid-surgery, and end of surgery). We analyzed the HRV changes across the whole surgical period and differences among good and poor sleepers. We also compared the SPI differences among groups. For baseline HRV analysis, we found significant differences in the RMSSD (p = 0.043), pNN50 (p = 0.029), VLF power (p = 0.035), LF power (p = 0.004), and HF power (p = 0.037) between the good and poor sleeper groups. However, all intergroup differences disappeared after anesthesia induction. Temporal HRV changes significantly among different perioperative stages (RMSSD, p < 0.001; pNN50, p = 0.004; LF, p < 0.001; and HF, p < 0.001). Patients with different sleep qualities did not exhibit different SPI levels in all four periods. Poor sleepers exhibited attenuated parasympathetic activities at the baseline but no differences after the induction. Nociceptive/anti-nociceptive balance seems not be altered by poor sleep condition under general anesthesia.
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Metadaten
Titel
Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers
verfasst von
Chun-Ning Ho
Pei-Han Fu
Jen-Yin Chen
Kuo-Chuan Hung
Jia-Hui Chang
Chung-Kang Peng
Albert C. Yang
Publikationsdatum
01.12.2020
Verlag
Springer Netherlands
Erschienen in
Journal of Clinical Monitoring and Computing / Ausgabe 6/2020
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-019-00450-5

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