Timoshenko A.V., Alkhatib N., Minasyan P.N., Kotov V.N., Mikhalskaia P.V., Kastyro I.V., Popadyuk V.I., Ganshin I.B. Central mechanisms of regulation of the stress response in rhinoseptoplasty with surgical correction of nasal valves. Head and Neck. Russian Journal. 2026;14(1):106–112
DOI: https://doi.org/10.25792/HN.2026.14.1.106-112
Observed postoperative heart rate variability (HRV) patterns reflect known interactions between the brain and the autonomic nervous system during acute stress. A high vagosympathetic index and increased very-low-frequency (VLF) power indicate active activation of brain stress centers, while high high-frequency (HF) power and a low centralization index reflect vagal dominance and cortical inhibition of stress responses. After rhinoseptoplasty, these dynamics were modulated by analgesic efficacy: excellent pain control with lornoxicam maintained a «recovery mode»-like state of the brain and heart (parasympathetic/vagal dominance and minimal anxiety signaling), whereas other medications were associated with a «stress mode» pattern (enhanced sympathetic outflow due to brainstem and limbic system activation). Our results confirm that HRV can serve as a noninvasive indicator of a patient’s neurocardiac stress state, integrating pain perception, autonomic regulation, and even brain activity. Effective analgesia during head and neck surgery not only improves patient comfort but can also maintain autonomic homeostasis and prevent excessive central nervous system activation.
Key words: rhinoseptoplasty, pain syndrome, analgesia, HRV
Conflict of interest. The authors have no conflicts of interest.
Funding. Absent.