title: Analysis of heart rate variability as an index of noncardiac surgical stress.
abstract: Measurement of heart rate variability (HRV) is useful in assessing the function of the autonomic nervous system and in staging of clinical diseases. The purpose of this study is to assess a feasibility of HRV for evaluating surgical stress during the noncardiac perioperative period. Standard deviation of normal-to-normal RR intervals (SDNN) and HRV triangular index derived from 24-h Holter ECC were measured in 24 patients undergoing digestive surgery. Holter ECG was performed at 1 day before operation, the first day (postoperative day 1: POD1), and the 7th day (POD7) after operation. Indices of HRV were compared with factors influencing surgical stress, such as duration of the operation and amount of blood loss during the operation, and postoperative complications. The SDNN and HRV triangular index decreased significantly on POD1 and recovered on POD7 (P < 0.05). Heart rate variability indices correlated significantly to duration and blood loss of operation (both P < 0.05). In 7 patients with postoperative complications, HRV indices were statistically lower than those in patients without complications on POD1 (P < 0.05). Our results indicate that HRV may provide useful information with respect to surgical stress.
authors.affiliation: Department of Surgery, National Hospital Organization Takamatsuhigashi National Hospital, Otsu-8, Shinden, Takamatsu 761-0193, Japan. ushiyamt@takamatu.hosp.go.jp
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ushiyama
authors.forename: Katsufumi
authors.initials: K
authors.lastname: Mizushige
authors.forename: Hisao
authors.initials: H
authors.lastname: Wakabayashi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Nakatsu
authors.forename: Ken
authors.initials: K
authors.lastname: Ishimura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Tsuboi
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeta
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm / Q000502:physiology*; D013505:Digestive System Surgical Procedures; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D013314:Stress, Mechanical