Differences in heart rate variability may be related to the appearance of postoperative pain in patients undergoing breast cancer surgery.
Differences in heart rate variability may be related to the appearance of postoperative pain in patients undergoing breast cancer surgery.
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DOI：
10.1186/s40981-017-0123-4
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发表时间：
2017
影响因子：
0.9
通讯作者：
Saito S
中科院分区：
文献类型：
--
作者：
Uchida S;Kadoi Y;Saito S
一些报告强调了心率变异性（HRV）与术后疼痛程度之间的关系。这项研究回顾性地研究了心率变异性的差异是否可能与接受乳腺癌手术的患者术后疼痛的出现有关。我们回顾性分析了 20 名在进入麻醉后监护室 (PACU) 后立即无疼痛的术后患者，分为两组：A 组 (n = 16) 在进入 PACU 时没有疼痛，出院时保持无疼痛（手术后 12 小时）； B 组 (n = 4) 包括入院 PACU 时没有疼痛的患者，但术后 1 小时疼痛加剧，需要在 PACU 进行干预。进入 PACU 后立即和手术后 2 小时测量 HRV；这包括低频功率 (LF)、高频功率 (HF) 和 LF/HF 变量。进入 PACU 时（到达后立即），A 组的 HF 和 LF/HF 与 B 组相比有显着差异：HF，A 组，35.4 ± 18.1； B 组，64.2 ± 9.5*；低频/高频 A 组，2.7 ± 2.4； B 组，0.6 ± 0.2*，*p < 0.05)。进入 PACU 后，两组之间的数值评定量表（NRS）没有显着差异。术后1小时，B组NRS升高，术后1小时使用镇痛药前两组NRS值存在显着差异（NRS，A组，1.0±0.9；B组，4.0±1.4*，*p<0.01）。 A 组患者术后至少 12 小时内无需使用镇痛剂。与术后 1 小时内疼痛加剧的患者相比，术后 12 小时内无疼痛的患者在到达 PACU 后立即观察到较低的 HF 和较高的 LF/HF 值。数据表明 HRV 的差异可能与术后疼痛的出现有关。
Some reports have highlighted the relationship between heart rate variability (HRV) and the degree of postoperative pain experienced. This study retrospectively examined whether differences in heart rate variability may be related to the appearance of postoperative pain in patients undergoing breast cancer surgery. We retrospectively analyzed 20 postoperative patients who had no pain immediately upon admission to the post-anesthesia care unit (PACU), divided into two groups: group A (n = 16) had no pain on admission to PACU, remaining pain free upon discharge (12 h after surgery); group B (n = 4) comprised patients with no pain on admission to PACU but who experienced increasing pain requiring intervention in PACU 1 h after surgery. HRV was measured immediately on admission to PACU and 2 h after surgery; this included variables of low-frequency power (LF), high-frequency power (HF), and LF/HF. There were significant differences in HF and LF/HF in group A compared with those in group B on admission to PACU (immediately after arrival): HF, group A, 35.4 ± 18.1; group B, 64.2 ± 9.5*; LF/HF group A, 2.7 ± 2.4; group B, 0.6 ± 0.2*, *p < 0.05). There was no significant difference in the Numerical rating scale (NRS) between the two groups immediately after admission to PACU. At 1 h after the surgery, NRS in Group B increased, and there were significant differences in NRS values between the two groups 1 h after surgery prior to the use of analgesic agents (NRS, group A, 1.0 ± 0.9; group B, 4.0 ± 1.4*, *p < 0.01). Patients in group A required no analgesic agents for at least 12 h after surgery. Lower HF and higher LF/HF values immediately after arrival in PACU were observed in patients remaining pain free for 12 h after surgery compared to patients who experienced increasing postoperative pain 1 h after surgery. The data suggest that differences in HRV may be related to the appearance of postoperative pain.