SPECIFIC FEATURES OF HEART RATE VARIABILITY IN CHILDREN WITH ENT PATHOLOGY IN NEED OF SURGICAL TREATMENT

Abstract

Detection of anesthetic risk factors in children with ENT diseases in need of surgery is one of the most important issues in pediatric anesthesiology. The objective of the study: to investigate specific features of heart rate variability in children with chronic ENT pathology in need surgical treatment with general anesthesia. Subjects and methods. 79 children in the age from 7 to 14 years old were examined. The patients were divided into three groups depending on the main disease. Group 1 included 15 (21%) children who had only been diagnosed with hyperplasia of the tonsils; Group 2 included 13 (18%) children with impaired nasal patency; Group 3 consisted of 22 (31%) children who had hyperplasia of the tonsils combined with nasal obstruction; and Group 4 consisted of 21 children who had neither hyperplasia of the tonsils nor nasal obstruction. The criterion for nasal obstruction was the following: decrease in the total volume of flow below 400 ml/s, a flow increase between 150 and 300 Pa (∆V) below 20%, an increase in the total resistance above 0.5 Pa ⋅ ml-1 ⋅ s-1. When assessing heart rate variability, standard parameters were evaluated. Results. It was found out that chronic inflammatory ENT diseases altered the vegetative pattern depending on the localization of the pathology: in case of adenoid vegetations there was a parasympathetic vegetative dysfunction, and in case of hyperplasia of the tonsils, it was of the sympathetic type. Conclusion. Pre-operative assessment of heart rate variability in children with ENT pathology allows identifying risk factors of hemodynamic disorders during anesthesia and preventing the use of drugs providing an undesirable effect on the vegetative nervous system.

Keywords

• heart rate variability
• anesthetic risks
• children
• ent diseases
• anesthetic complications