Background
The autonomic nervous system is cardinal for maintaining systemic homeostasis and is pivotal for the baseline regulation and modulation of vital cardiovascular, hemodynamic, respiratory, gastrointestinal, and thermoregulatory functions. Pre-existing autonomic reflex dysfunction in surgical patients accentuates perioperative hemodynamic fluctuations during stressful events like direct laryngoscopy, endotracheal intubation and extubation and hence, predispose to deleterious major adverse cardiac events in patients with the pre-existing comorbid illness. This can prolong their duration of hospital stay, contributing to significant morbidity and mortality.
Purpose
Our proposed study will inform the incidence of Cardiac Autonomic Dysfunction (CAD) in the elective neurosurgical population which is hitherto unknown in Indian scenario. This study will also likely identify the potential risk factors for CAD in neurosurgical patients, which can be helpful in predicting adverse perioperative outcomes. Preoperative risk stratification and prediction will facilitate early and appropriate interventions to minimize morbidity and mortality in the perioperative period associated with surgery/anesthesia in patients with CAD.
Methods
In this single-centre prospective observational study, we will recruit consenting adult patients of either gender, between 18-80 years, undergoing elective brain tumor surgery. We will perform a preoperative bedside ANS assessment and ascertain the prevalence of CAD among elective neurosurgical patients based on the indices of heart rate variability.
Funding
The Vision Group on Science and Technology (VGST), under the aegis of Karnataka Science and Technology Promotion Society (KSTePS), Government of Karnataka
