Dynamic perioperative changes in baroreflex sensitivity predict postoperative pain

Steep perioperative BRS declines, particularly among individuals with initially high values, may reflect autonomic destabilization and reduced baroreflex-mediated inhibition of nociception. These findings identify ΔBRS as a dynamic and mechanistically informative predictor of postoperative pain. Perioperative BRS monitoring could support individualized risk stratification and guide interventions aimed at stabilizing autonomic function to improve recovery outcomes.