Functional Capacity Through HRV in Multimodal Rehabilitation for Adult Surgery

Investigation Group Anesthesia, Resuscitation, And Perioperative Medicine of Aragon490 enrolled

Overview

This prospective, observational cohort study investigates heart rate variability (HRV) monitoring using the Analgesia Nociception Index (ANI) monitor in adult patients undergoing major surgery within a multimodal rehabilitation program. The objective is to correlate HRV indices with functional capacity, physiological reserve, and frailty during the prehabilitation phase.

The study evaluates HRV using the ANI monitor to determine adaptation to training load, optimize analgesic and anesthetic dosing, and predict postoperative complications. The HRV indices of Energy (SDNN) and ANI (HFnu) are monitored at two points: the initial pre-anesthesia consultation and one week before surgery. Results will be compared with the 6-minute walk test, MUST nutrition screening scale, and clinical frailty and FRAIL scales.

Study Type

OBSERVATIONAL

Enrollment

490

Conditions

Frailty in Adult Surgery

Interventions

Analgesia Nociception Index (ANI) MonitorDEVICE

Non-invasive monitoring of HRV to evaluate autonomic nervous system activity using the indices of Energy (SDNN) and ANI (HFnu).

Trimodal PrehabilitationBEHAVIORAL

Program of physical exercise, nutritional supplementation, and psychological support according to the RICA guidelines of the Spanish Group for Multimodal Rehabilitation.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients over 18 years of age * Scheduled for major adult surgery * Any ASA classification * Signed informed consent Exclusion Criteria: * Urgent surgery * Severe cognitive impairment * Patient refusal to participate * Pediatric patients * Cardiac arrhythmia or atrial fibrillation

Locations (1)

Miguel Servet University Hospital

Zaragoza, Spain

RECRUITING

Outcomes

Primary Outcomes

Correlation of HRV indices with functional capacity and frailty

Evaluation of the correlation between HRV indices (Energy and ANI) and current parameters used to assess functional capacity, physiological reserve, and frailty.

Time frame: From initial pre-anesthesia consultation to 30 days postoperatively

Secondary Outcomes

Reduction of postoperative complications

Evaluation of the relationship between higher preoperative functional reserve and lower number of complications, mortality, and hospital stay at 30 days postoperatively.

Time frame: 30 days postoperatively

Intraoperative decisions based on HRV

Analysis of whether HRV monitoring guides the workload during prehabilitation and the titration of drugs during surgery.

Time frame: During the perioperative period

Central Contacts

Cristian Aragón-Benedí, M.D., Ph.D.,

CONTACT

+34625408866 cristianaragon@outlook.com

Data from ClinicalTrials.gov

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