New opportunities in the diagnostics of stress state in surgical rhinology

Continuous ECG recordings were obtained using 24-hour Holter monitors (Shiller MT-200) in 60 healthy men (50 patients with nasal septum deviation (NSD) and in 10 men of control group) aged 25 to 39 years old. Patients with NSD had a septoplasty. They were divided into five groups. Group 1 consisted of patients without analgesia. Group 2, 3, 4 and 5 patients received metamizole sodium, diclofenac, ketorolac and ketamine respectively. Control group was marked as Group 0. The monitoring began 30 minutes before surgery and ended 24 hours after record beginning. Circadian index (CI) was calculated from both heart rate (HR) and ST segment (STS) data. Simple linear regression was performed between HR-derived and STS-derived CIs for each groups. Inter-groups Student's t-test was calculated. Obtained coefficients of determination varied from 0.60 to 0.87. STS- and HR-derived CIs were only statistically inequivalent in Group 1 (p < 0.05). Inter-groups analysis showed that 0 and 3 Groups were statistically equivalent and there was CI decrease in groups 4 and 5 (p<0.05). Tendency to decrease CI observed in Group 2. CI can be calculated not only heart rate, but also by the deviation of CST, which indicates the importance of CST not only as ischemia marker but also as an indicator of autonomic nervous system arousal.

circadian index, septoplasty, ST segment, autonomic nervous system