心率变异性的差异可能与接受乳腺癌手术患者术后疼痛的出现有关。

Differences in heart rate variability may be related to the appearance of postoperative pain in patients undergoing breast cancer surgery.

作者信息

Uchida Shinya, Kadoi Yuji, Saito Shigeru

机构信息

Department of Anesthesia, Gunma Cancer Center, Maebashi, Japan.

2Department of Anesthesiology, Gunma University Hospital, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511 Japan.

出版信息

JA Clin Rep. 2017;3(1):56. doi: 10.1186/s40981-017-0123-4. Epub 2017 Oct 11.

DOI:10.1186/s40981-017-0123-4

PMID:29457100

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5804653/

Abstract

BACKGROUND

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.

FINDINGS

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 ( = 16) had no pain on admission to PACU, remaining pain free upon discharge (12 h after surgery); group B ( = 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*, * < 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*, * < 0.01). Patients in group A required no analgesic agents for at least 12 h after surgery.

CONCLUSIONS

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.

摘要

背景

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。本研究回顾性地探讨了心率变异性的差异是否可能与接受乳腺癌手术患者的术后疼痛出现有关。

研究结果

我们回顾性分析了20例术后患者，这些患者在进入麻醉后护理单元（PACU）时即刻无疼痛，分为两组：A组（n = 16）进入PACU时无疼痛，术后12小时出院时仍无疼痛；B组（n = 4）包括进入PACU时无疼痛但术后1小时在PACU经历疼痛加剧需要干预的患者。在进入PACU时和术后2小时即刻测量HRV；这包括低频功率（LF）、高频功率（HF）和LF/HF变量。在进入PACU（到达后即刻）时，A组与B组相比，HF和LF/HF存在显著差异：HF，A组，35.4±18.1；B组，64.2±9.5*；LF/HF，A组，2.7±2.4；B组，0.6±0.2*，P<0.05）。进入PACU后两组之间的数字评分量表（NRS）无显著差异。术后1小时，B组的NRS升高，在使用镇痛剂之前，术后1小时两组之间的NRS值存在显著差异（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小时不需要镇痛剂。