Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (11): 85-91.doi: 10.6040/j.issn.1671-7554.0.2020.0113

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Clinical observation of heart rate variability in patients with gastric cancer during perioperative period under the guidance of enhanced recovery after surgery

ZHI Mengwei1, JIANG Zhiwei2, DAI Xinjuan3, WANG Gang2, CHENG Wei2   

  1. 1. School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China;
    2. Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China;
    3. Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China
  • Published:2020-11-04

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Abstract: Objective To explore the changes of heart rate variability(HRV)in patients undergoing laparoscopic radical gastrectomy under the guidance of enhanced recovery after surgery(ERAS). Methods The clinical data of 50 patients who received laparoscopic radical gastrectomy during Jan. 2019 and Dec. 2019 were retrospectively analyzed. According to whether ERAS concept was adopted, the patients were divided into the control group(n=25)and ERAS group(n=25). Patients in the control group received traditional perioperative management, while patients in the ERAS group received multimodal health education, fluid management, multimodal analgesia, early enteral nutrition, early ambulation and so on. Perioperative HRV parameters were compared between the two groups, including standard deviation of NN intervals(SDNN), triangle index, number of pairs of successive NNs that differ by more than 50ms(pNN50), low frequency(LF), high frequency(HF), low frequency/high frequency(LF/HF). The serum hypersensitive C-reactive protein level in the two groups were also observed. Results In postoperative days 1-4, SDNN was significantly higher in the ERAS group than in the control group(P<0.05). In postoperative days 1, 2, 3 and 5, triangle index was significantly higher in the ERAS group than in the control group(P<0.05). In postoperative days 2-4, LF/HF was significantly higher in the ERAS group than in the control group(P<0.05). In postoperative days 1-5, there were no differences in LF, HF and LF/HF between the two groups(P>0.05). In postoperative days 1 and 3, C-reactive protein was significantly lower in the ERAS group than in the control group(P<0.05). Conclusion ERAS improves HRV, reduces surgical stress and inflammatory response, and promotes recovery in patients undergoing laparoscopic radical gastrectomy.

Key words: Enhanced recovery after surgery, Gastric cancer, Heart rate variability, Autonomic nervous system, Stress response

CLC Number: 

  • R619
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