Changes in heart rate variability after rhinosurgical interventions

Purpose: to study changes in heart rate variability (HRV), as an indicator of the stress response, after rhinosurgical interventions. Material and methods . A study of heart rate variability was conducted in 98 patients in the perioperative period who underwent open rhinoplasty (1st group, 33 patients), open rhinoplasty with simultaneous septoplasty (2nd group, 33 patients), and septoplasty (3rd group, 32 patients). Heart rate variability was assessed before surgery, 3, 6, 24 and 48 hours after surgery. The low frequency component (LF), high frequency component (HF), and very low frequency component (VLF) of HRV were studied. Results . In the 3rd group of patients, compared with the data before surgery, the high-frequency component of HRV significantly decreased on the 3rd and 24th hours after surgery ( p < 0.001), but increased after two days ( p < 0.001). 3 hours after surgery, HF HRV in patients of 1st group was significantly higher than in patients of groups 2nd and 3rd ( p < 0.001). In the second group, a significant decrease in HF was noted in the first 3 ( p < 0.001), 6 hours ( p < 0.01), 24 hours ( p < 0.05) and 48 hours ( p < 0.001) of the postoperative period, compared with data before surgery. In 3rd group, at intervals after surgery of 3 and 24 hours ( p < 0.001), as well as 6 hours ( p < 0.001), LF was significantly lower than before septoplasty. 3 hours after surgery, the VLF in the rhinoplasty group was significantly higher than in the other groups ( p < 0.001). At the 6th hour there were no differences between the groups. After 24 hours, in the septoplasty group, VLF was significantly lower than in 11st and 2nd groups ( p <0.01). Conclusion. Septoand rhinosptoplasty provoke an inadequate low response from the sympathetic nervous system in the first hours after surgery, which is manifested by low LF power and indicates a violation of adaptive responses maladaptation. A decrease in VLF power in the first 3 hours after septoand rhinoseptoplasty indicates a pronounced stressor effect, which leads to low adaptive capabilities compared to rhinoplasty, that is, maladaptation within the specified period.