Heart rate variability in different regional abdominal wall blocks in children

Abstract

The analgesic efficacy of different abdominal wall blocks is not studied well. Peripheral regional blocks may have advantages over the central ones in terms of safety and duration of analgesia. Heart rate variability (HRV) analysis is one of the methods to assess the adequacy of analgesia during surgery.The aim – to compare the HRV values during anterior abdominal wall surgeries in children under different types of regional anesthesia.Materials and Methods. The study included 56 children who underwent anterior abdominal wall surgery under regional anesthesia (caudal anesthesia (n=15), Th12-L1 thoraco-lumbar paravertebral block (n=14), transversusabdominis plane (ТАР) block (n=15), ilioinguinal-iliohypogastric nerves block (n=12) with 0.25 % bupivacaine) in combination with propofol-based general anesthesia. General and spectral HRV parameters were studied.Results. General HRV parameters did not differ among groups. Spectral HRV parameters in all groups corresponded to an adequate level of analgesia. The power of high-frequency component of the HRV spectrum (HF and HFn) in caudal anesthesia and paravertebral block groups was higher compared to ТАР-block and ilioinguinal-iliohypogastric nerves block groups. That indicates a higher level of analgesia with caudal and paravertebral blocks.Conclusions. Central and peripheral regional blocks provide an adequate analgesia during anterior abdominal wall surgery in children. Caudal and paravertebral blocks have higher levels of antinociceptive protection during anterior abdominal wall surgery in children.LFn, HFn and LF/HF are optimal variables for pain and poor analgesia diagnosis.