Heart Rate Variability and Anxiety as Predictors of Emergence Agitation After Septorhinoplasty

Summary

This prospective observational study aims to evaluate whether preoperative heart rate variability (HRV) and anxiety are associated with, and can help predict, emergence agitation in adult patients undergoing elective septorhinoplasty under general anesthesia. Preoperative anxiety will be assessed using a visual analog scale (VAS) and the State-Trait Anxiety Inventory (STAI-1). Resting HRV will be recorded preoperatively using a chest-strap heart rate monitor and HRV metrics (e.g., SDNN, RMSSD, LF/HF) will be derived. Emergence agitation will be assessed in the post-anesthesia care unit (PACU) using the Richmond Agitation-Sedation Scale (RASS) during the early recovery period. Secondary observations will include early postoperative events such as postoperative nausea and vomiting (PONV) and laryngospasm. The study is planned to enroll approximately 100 participants.

Eligibility

Inclusion Criteria:

* Age 18 to 65 years
* ASA physical status I-II
* Scheduled for elective septorhinoplasty under general anesthesia
* Able to provide informed consent and complete questionnaires

Exclusion Criteria:

* ASA physical status III or higher
* Pregnancy or breastfeeding
* Known dysrhythmia/arrhythmia or autonomic dysfunction, or use of medications that may affect autonomic function/HRV
* Diagnosed anxiety disorder
* Use of preoperative anxiolytic medication
* Inability to understand/complete the anxiety scales/questionnaires
* Emergency surgery

Conditions5

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