Perioperative medicine & outcomes
Effect of perioperative autonomic nervous system imbalance on surgical outcomes: a systematic review
Authors' conclusion
Maintaining balance of the sympathetic and parasympathetic nervous systems is an important prospect in perioperative medicine that could benefit surgical patients' short- or long-term recovery.
Study context
- Population
- Surgical patients with perioperative autonomic nervous system imbalance
Pooled result
As reported in the abstract
- Perioperative autonomic nervous system (ANS) imbalance (sympathetic hyperactivation, low parasympathetic tone) drives systemic stress responses, cardiovascular instability, impaired tissue repair and immunosuppression, increasing infection risk, neurocognitive decline and multiorgan dysfunction
- Surgical trauma, anaesthesia, pain, hypothermia and psychological stressors contribute; low parasympathetic tone makes the cholinergic anti-inflammatory pathway less effective
- High sympathetic activity promotes catecholamine surges and pro-inflammatory cytokine release
- Dexmedetomidine, β-blockers, electroacupuncture and temperature management have potential to restore ANS balance
Original publication
Effect of perioperative autonomic nervous system imbalance on surgical outcomes: a systematic review. Br J Anaesth. Published 4 July 2025. doi:10.
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