This prospective observational cohort study will assess whether perioperative short-term heart rate variability (HRV) indices and early inflammatory cytokine levels are associated with respiratory and cardiac adverse events in children undergoing elective adenoidectomy, tonsillectomy, or adenotonsillectomy under general anesthesia. HRV will be recorded noninvasively from 30 minutes before surgery until discharge from the post-anesthesia care unit. Serum cytokines will be measured from 3 mL of residual blood obtained after induction of anesthesia. The study aims to identify perioperative physiologic markers associated with a lower or higher risk of adverse events, thereby supporting safer anesthetic planning.
Eligibility
Sex
ALL
Min age
5 Years
Max age
9 Years
Healthy volunteers
No
Inclusion Criteria:
* Age 5-9 years;
* elective adenoidectomy, tonsillectomy, or adenotonsillectomy operation
* ASA physical status I-II;
* surgery planned under general anesthesia;
* able to undergo standard endotracheal intubation and standard anesthetic protocol
-; no dermatologic or cardiac barrier to preoperative Holter monitoring;
* written informed consent provided by parent/legal guardian.
Exclusion Criteria:
* ASA physical status III or higher; congenital heart disease, arrhythmia, or cardiac conduction disorder;
* known neurologic disease (e.g., epilepsy or cerebral palsy);
* psychiatric diagnosis;
* chronic inflammatory or immune-system disease;
* acute infection within 2 weeks before surgery
* regular steroid, immunosuppressive, or anti-inflammatory medication use;
* endocrine disease such as uncontrolled thyroid disease;
* preoperative hemodynamic instability;
* major unexpected intraoperative complication or ICU requirement;
* intraoperative atropine, lidocaine, beta-blocker, or epinephrine use;
* history of prematurity or syndromic disease;
* parent/legal guardian declines consent.
Primary outcome measure(s)
HRV parameters' effect on perioperative cardiac events — 1 day. Until discharge from the PACU (same day) Association between perioperative HRV parameters and perioperative respiratory/cardiac adverse events. HRV measures: SDNN, RMSSD, LF, HF, and LF/HF derived from Holter/ECG recordings. Adverse events include laryngospasm, bronchospasm, apnea/hypopnea, breath-holding, hypoxemia/desaturation, stridor, severe cough, and clinically relevant cardiac events. Time Frame: From 30 minutes before surgery until discharge from the PACU, up to 1 day.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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