Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers
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ORIGINAL RESEARCH
Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers Chun‑Ning Ho1 · Pei‑Han Fu1 · Jen‑Yin Chen1 · Kuo‑Chuan Hung1 · Jia‑Hui Chang2 · Chung‑Kang Peng3 · Albert C. Yang3,4 Received: 22 August 2019 / Accepted: 15 December 2019 © Springer Nature B.V. 2019
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
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