The Value Of Heart Rate Variability In Judging Acute Postoperative Pain In Children With Congenital Heart Disease

Objective: To explore the feasibility of heart rate variability(HRV)in judging acute pain after pediatric cardiac surgery.Methods: Pediatric congenital heart disease patients were transferred to the ICU.After screening,the ECG signals were collected and stored using the Holter monitor to perform offline HRV analysis.The FLACC score was used to evaluate the pain status of the children.Analyze the data and determine the value of HRV in judging acute postoperative pain in children.Results: A total of 138 children with congenital heart disease who were transferred to the ICU after cardiac surgery were enrolled,including 77 males and 61 females.FLACC scores showed 82 cases(59.4%)with mild discomfort;28 cases(34.8%)with moderate pain;and 8 cases(5.8%)with severe pain discomfort.Spearman correlation analysis showed that the correlation between FLACC score and LF/HF was 0.879,P < 0.001.The receiver operating characteristic curve(ROC)was plotted.The area under the FLACC score curve was 0.924(95% confidence interval: 0874-0.975,P = 0.000);the area under the LF/HF curve was 0.892(95% confidence interval 0.827-0.956,P < 0.001).The sensitivity and specificity of the FLACC score were compared with the sensitivity and specificity of LF/HF.The sensitivity was ?2=0.003,P > 0.05;the specificity ?2 = 0.073,P > 0.05.Conclusion: The LF/HF parameters in the objective index HRV have a good correlation with the FLACC score.LF/HF may be a biomarker for improving the recognition rate of acute pain after pediatric cardiac surgery.Given the limitations of this study,a larger sample size study is needed in the future to further validate the value of HRV in judging pain.