Features of the heart rate variability in the perioperative period after adenotomy in children

Abstract

Aim. Study course of perioperative period after adenotomy in children in different ways of general anesthesia by examining indicators of heart rate variability and efficacy of postoperative analgesia.Materials and methods. To study included 70 children aged from 6 to 8 years, which was held adenotomy. Patients were divided into 3 groups: group I (n = 28) - operated under conditions of intravenous anesthesia based on propofol combined with fentanyl; group II (n=23) – operated under conditions of inhalation anesthesia by sevoflurane in combination with fentanyl and analginum; group III (n=19) – operated under conditions of intravenous anesthesia based on thiopental sodium combined with fentanyl. Differences were considered significant at p <0.05 using Student t-test.Results. Indicators of heart rate variability indicated that in the extubation stage in all groups of patients revealed high activity of the sympathetic tone with the trend of decline in the morning after surgery. Statistically higher activity of the sympathetic part of the autonomic nervous system was in patients of group III - 1 hour after surgery compared with patients groups I and II (p <0,001 and p <0,01, respectively). After 1 hour after surgery on the scales "Faces" and "Oucher" scores indicated that the child "a little hurt" in all groups of patients In the dynamics of observation in all groups tended to reduce the intensity of pain. An interpretation of scores on the FLACC scale indicated that patients in both groups felt comfortable.Conclusions. It was found that in patients in all groups there are changes in the nervous regulation of heart rate variability, characterized by increased activity of the sympathetic division of the autonomic nervous system. Postoperative anesthesia by 10 mg / kg ibuprofen provides effective analgesia