This study aims to evaluate the utility of Analgesia Nociception Index (ANI) monitoring as a predictive and preventive tool for TCR during septoplasty. By comparing standard anesthetic monitoring with ANI-guided analgesia, this research seeks to determine whether maintaining optimal autonomic balance can reduce the incidence of trigeminal cardiac reflex (TCR) and improve intraoperative cardiovascular stability.
Age 18-60 years.
American society of anesthesiologist physical status I-II
Indicated for primary septoplasty.
Known cardiac arrhythmias or conduction disorders.
Use of beta-blockers or antiarrhythmic medications.
Previous nasal surgery and Combined nasal procedures.
Inability to obtain reliable Analgesia Nociception Index readings.
Adult patients scheduled for elective nasal septoplasty under general anesthesia will be enrolled.
Cohort
Prospective
Not listed
Primary Outcome - Incidence of trigeminal cardiac reflex
Defined as a decrease in heart rate \>20% from baseline during surgery.
Time interval between Analgesia Nociception Index drop and subsequent heart rate decrease (early warning window).
Time in minutes between occurrence of Analgesia Nociception Index drop and subsequent heart rate decrease
Total intraoperative opioid consumption.
The amount in milligram of opioid consumption.
Incidence of hypotension or arrhythmias.
Decrease mean arterial pressure less than 60mmgh or occurrence of tachycardia or bradycardia.
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