https://doi.org/10.1140/epjs/s11734-026-02159-4
Regular Article
Study of the degree of centralization of cardiac activity regulation in the event of rhinoseptoplasty with correction of the nasal valves
1
Department of Otorhinolaryngology, RUDN University, Miklukho-Maklaya St. 6, 117198, Moscow, Russia
2
Department of Clinical Physiology and Non-Drug Therapy, RUDN University, Miklukho-Maklaya St. 6, 117198, Moscow, Russia
3
Department of Plastic Surgery, RUDN University, Miklukho-Maklaya St. 6, 117198, Moscow, Russia
a
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Received:
24
December
2025
Accepted:
26
January
2026
Published online:
13
February
2026
Abstract
The postoperative HRV patterns we observed mirror known brain–autonomic interactions during acute stress. High LF/HF ratios and VLF elevations signal robust engagement of brain stress centers (sympathetic and HPA axis activation), while high HF power and low centralization index reflect dominance of vagal pathways and cortical inhibition of stress responses. After rhinoseptoplasty, these dynamics were clearly modulated by analgesic efficacy: lornoxicam’s superior pain control maintained a brain–heart state akin to “recovery mode” (parasympathetic/vagal predominance and minimal alarm signaling), whereas the other medications were associated with a “stress mode” pattern (heightened sympathetic outflow driven by brainstem and limbic activation). Our findings reinforce that HRV can serve as a non-invasive surrogate for the patient’s neurocardiac stress status, integrating pain perception, autonomic regulation, and even brain activity. Effective analgesia in head and neck surgery not only improves patient comfort, but may also preserve autonomic homeostasis and prevent excessive central stress activation, as evidenced by a more favorable HRV profile. This mind-heart interplay underscores the importance of adequate pain management: by damping acute pain signals, we likely temper the entire central stress response, which is in turn reflected in more balanced HRV readings and, ultimately, better postoperative recovery for the patient.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2026
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
