Heart rate variability in patients recovering from general anaesthesia

We studied heart rate variability (HRV) using spectral analysis techniques in 58 adult patients recovering from general anaesthesia. The aim was to discover how HRV was affected by a variety of common preoperative, intraoperative and postoperative factors. ECG, respiration, level of consciousness, nausea, pain and arterial pressure were recorded during the first hour of recovery from general anaesthesia. HRV was found to decrease with increased weight, age, complexity of operation, use of reversal agents for neuromuscular block and preoperative beta-block. These effects were not mediated by changes in respiration. HRV was unaffected by administration of morphine. The level of nausea or pain had no effect on HRV except that pain decreased the relative ratio of high frequency to low frequency power within the power spectrum. In the group of patients that did not receive reversal agents, there was an abrupt increase in HRV when patients became responsive to verbal command.