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Heart rate variability for the objective measurement of stress and anxiety in caregivers and their children undergoing surgery – an observational study (Pulse Star)

Project Grant

Anaesthesia can be a stressful time for children. Perioperative anxiety increases the risk of emergence delirium, post-operative behaviour changes and poor compliance with future episodes of healthcare. 

 

Caregivers often accompany their child to theatre to reduce the child’s anxiety, however if the caregiver is feeling stressed and anxious themselves, it can make the child feel worse. 

 

One problem that is holding back successful research in this area is how to effectively measure the stress and anxiety levels for both the child and the caregiver. 

 

Currently we rely on skilled observers to rate anxiety, but this is labour intensive, subjective and inconsistent. One promising solution is to use heart rate variability which can be used to measure someone’s general level of stress and also moments of increased stress. 

 

Previously it was necessary to do a formal ECG to determine heart rate variability and this made the measurement impractical in many clinical situations. Now, it is possible to obtain accurate ECG data with a sensor worn on the wrist, arm or chest.  

 

This study aims to show the feasibility, acceptability and clinical utility of heart rate variability measured using a wearable device in children and their caregivers at induction of anaesthesia. 

 

A/Professor Paul Lee-Archer, Queensland Children’s Hospital, Dr Karin Plummer, Griffith University, Gold Coast, Professor Stewart Trost, School of Human Movement and Nutrition, University of Queensland. 

The project was awarded A$70,000 funding through the ANZCA research grants program for 2026.