General Anesthesia and Autonomic Nervous System in Children

Study Overview
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Brief Summary
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The objective of the ANESPEDIA study is to describe in a pediatric population (aged from 4 to 8 years old) receiving elective surgery, the impact of general anesthesia on autonomic nervous system and their kinetics of early postoperative course (24 hours).

Detailed Description
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Some physiological factors such as sport activity or pathological as sepsis, certain chronic diseases or diabetes are known to modulate the overall autonomic activity and the intrinsic capacity of the individual to regulate its sympathovagal balance. These influences can alter the physiological autonomic balance sometimes with positive consequences on the Cardiac frequency-breathing control, blood pressure adjustment depending on the position of the individual, on the status of blood volume, but sometimes deleterious with bad regulation of sinus cardiac activity and respiration rate. General anesthesia is recognized as one of the factors that can modify more or less sustainable the sympathovagal autonomic balance. While many studies described the effects of anesthesia on the autonomic nervous system, most data are done in adult subjects. For the child who sees intrinsically autonomic physiological changes related to its maturative status, assessment of the impact of anesthesia in the pediatric population in per and postoperative was never realized.

Official Title
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General Anesthesia and Autonomic Nervous System in Children

Conditions
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Anesthesia, General

Intervention / Treatment
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* Device: Autonomic nervous system activity


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Post-anesthesia Monitoring in pediatric intensive care units or Pediatric Surgery Hospital North of Saint Etienne. Compendium of the form signed by the holder of parental authority Exclusion Criteria: Child with pathologies reaching the central nervous system or the brain stem. Children with a severe pathology of cardio-respiratory or heart being referred to treatment. Children requiring emergency surgery or trauma or septic or inflammatory context

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pediatric population from 4 to 8 years-old<br>Description of the Autonomic nervous system activity (parasympathetic activity) | Device: Autonomic nervous system activity<br>* Autonomic nervous system activity (parasympathetic activity) will be measured by electrocardiogram (holter) during 24 hours postoperative<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of parasympathetic activity evolution by heart rate variability | Parasympathetic activity evolution will be described by heart rate variability | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate variability (HRV) | HRV is measured by a 24H-Holter Electrocardiography (ECG). It is a composite outcome : SDNN, pNN30, pNN50, RMSSD, SD1, SD2, LF, VLF, LF/HF ratio and Ptot indexes | 24 hours | 
| Heart rate variability (HRV) | HRV is measured by a 24H-Holter Electrocardiography (ECG). It is a composite outcome : HF, SDNN, pNN30, pNN50, RMSSD, SD1, SD2, LF, VLF, LF/HF ratio and Ptot indexes | at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22 and 24 Hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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General anesthesia, Autonomic nervous system, Children