Association between postsurgical pain and heart rate variability: protocol for a scoping review

Area of Science:

• Cardiology
• Anesthesiology
• Pain Medicine

Background:

• Surgical procedures can disrupt neuroendocrine and autonomic balance, impacting cardiac function.
• Cardiac complications are a major cause of death after non-cardiac surgery, with altered heart rate variability (HRV) being a predictive factor.
• The relationship between postsurgical pain and HRV is not fully understood, with potential confounding factors like analgesia.

Purpose of the Study:

• To conduct a scoping review of existing evidence on the association between postsurgical pain and HRV alterations.
• To synthesize current knowledge on how pain intensity relates to HRV in the early postoperative period.
• To identify gaps in research and inform future studies on postsurgical pain and cardiac complications.

Main Methods:

• A comprehensive scoping review of studies indexed in MEDLINE and EMBASE.
• Inclusion criteria focused on non-cardiac surgery, pain intensity measures, HRV measures, and their statistical association.
• Secondary outcomes included cardiovascular events and control for analgesic use and baseline HRV.

Main Results:

• The review synthesizes evidence linking postsurgical pain to HRV alterations.
• Identifies the need for further research to clarify the direct impact of pain versus other factors on HRV.
• Highlights HRV as a potential biomarker for postsurgical cardiac risk.

Conclusions:

• Postsurgical pain is associated with alterations in heart rate variability.
• Further research is needed to disentangle the effects of pain from other factors influencing HRV post-surgery.
• Understanding the postsurgical pain-HRV relationship can improve patient outcomes and cardiac risk prediction.