Selection of the optimal method of pain therapy for typical surgery at ENT clinic based on the evaluation of the circadian rhythm of heart rate

The article describes the characteristic features of circadian rhythms in heart rate under normal and stress conditions as a result of surgical interventions at ENT clinic using various analgesic schemes. The study included 45 physically healthy males aged 25 to 40 years divided into 4 groups depending on the method of perioperative analgesia: metamizole sodium group (n = 10), ketorolac group (n = 10), trimeperidine group (n = 10) and group of patients with anesthetic support (ketamine group, n = 5). A qualitative analysis of circadian profiles of heart rate was conducted. The study found that metamizole sodium and ketorolac groups were more likely to demonstrate changes in the configuration of the circadian HR profile, absence of sustained ventricular tachycardia and mild bradycardia at night. Trimeperidine group tended to tachycardia in the evening and night, though the heart rate profile did not show any marked deviations. In ketamine group, circadian HR rhythms were most positive. Recommendations are provided on the choice of the best method of analgesia in patients with concomitant diseases of the cardiovascular system.

оториноларингология, обезболивающая терапия, болевой синдром, частота сердечных сокращений, хроноструктура, биологические ритмы, циркадиан-ный профиль, otorhinolaryngology, analgesia, pain, heart rate, chronostructure, biological rhythms, circadian profile

1. Ефимочкина К.В., Пушкарь И.С., Березова Д.К., Попадюк В.И. Сбалансированная анестезия и аналгезия в ЛОР-хирургии искривлений перегородки носа и хронических тонзиллитов. Российская оториноларингология, 2009, 1: 17-22.

2. Чибисов С.М., Катинас Г.С., Рагульская М.В. Биоритмы и космос: мониторинг космобиосферных связей: монография. М.: Издательство «Капитал Принт», 2013: 442.

3. Щербук Ю.А., Волчков В.А., Боровских Н.А. Послеоперационная аналгезия (обзор). Вестник Санкт-Петербургского университета, 2009, 11 (2): 67-79.

4. Mads UW, Kehlet H. Characterization of persistent postoperative pain by quantitative sensory testing. European Journal of Pain. Supplements, 2010, 4, 4: 203-207.

5. Mourot A, Fehrentz T, Le Feuvre Y, Smith CM, Herold C, Dalkara D, Nagy F, Trauner D, Kramer RH. Rapid optical control of nociception with an ion-channel photoswitch. Nature Methods, 2012, 9: 396-402.

6. Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesthesia and Analgesia, 2002, 95 (3): 627-634.

7. Sansone RA, Sansone LA. Chronic Pain Syndromes and Borderline Personality. Innovations in Clinical Neuroscience, 2012, 9, 1: 10-14.

8. Zuther P, Gorbey S and Lemmer B. Chronos-Fit 1.06, 2009. URL: http://www.ma.uni-heidelberg.de/inst/phar/lehre/chrono.html.