Heart Rate Variability and Electroencephalography Analysis in Laparoscopic Surgery With or Without Transversus Abdominis Plane Block

Study Overview
=================
Brief Summary
-----------------
Heart rate variability(HRV) and electroencephalography(EEG) has been used widely in anesthetic practice nowadays. One of the most dominant applications is the nociception-analgesia balance. Some evidence support that heart rate variability correlates with perioperative stimulation and postoperative pain score. There are some new evidence support EEG correlated with anesthesia depth and analgesic balance. However, the heterogeneity between the studies and interference factors has limited their usage in clinical practice. On the other hand, peripheral nerve block is broadly used as a routine technique with general anesthesia, but few studies discuss the effect on heart rate variability. Our study focuses on the different HRV and EEG patterns of incision and insufflation during laparoscopic surgery with general anesthesia. Furthermore, we measure the effect of transversus abdominis plane nerve block to heart rate variability during surgery. By this comparison, we can discuss the influences of somatic stimulation, visceral stimulation, and pneumoperitoneum to heart rate variability, and then improve the accuracy of HRV-based nociception-analgesia monitors.

Official Title
-----------------
Heart Rate Variability and Electroencephalography Analysis in Laparoscopic Surgery With or Without Transversus Abdominis Plane Block

Conditions
-----------------
Autonomic Nervous System, Nerve Block, Laparoscopy, Anesthesia and Analgesia, EEG

Intervention / Treatment
-----------------
* Procedure: transversus abdominis plane block


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: ≥20 years of age male or female American Society of Anesthesiologists (ASA) physical status classification I or II capacity to give informed consent Exclusion Criteria: major cardiovascular and cerebral vascular disease, arrhythmia, respiratory disease, diabetes mellitus with evidence of neuropathy; ASA physical status classification III or greater; a documented or self-reported history of chronic pain; acute or chronic opioid analgesic use; dysautonomia; and intraoperative muscarinic anticholinergic administration during the time of monitoring.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pre-operative transversus abdominis plane block<br>The group with transversus abdominis plane block before laparoscopic surgeries with a standard pain control protocol | Procedure: transversus abdominis plane block<br>* transversus abdominis plane block group<br>|
| Traditional pain control group<br>The group with a standard pain control protocol | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Different heart rate variability pattern during laparoscopy | Different heart rate variability pattern in incision and inflation with or without TAP block | 6 months |