Effect of patient's breathing pattern on the stress changes in third molar extraction

Rhee, Sang Myung; Kim, Hyung Wook; Park, Yang Ho; Kim, Jin Cheol; Park, Jun Woo; Rhee, Sung Jun; Nyamdorj, Selenge; Ahn, Jae Mok

Abstract

PURPOSE: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats (RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern (0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min.
METHODS
These phases include before, during and after tooth extraction or anesthesia or something.36 patients'stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system (ANS) which represents the level of stress.
RESULTS
All HRV parameters including HF (high frequency), LF (low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz.
CONCLUSION
After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest after the anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.