Background and Objectives:The aim of this study was to evaluate the relationship between salivary alpha-amylase (sAA) and heart rate variability (HRV) indices in SDB children based on objective parameters of polysomnography (PSG). Materials and Method: This prospective study enrolled 67 children who underwent a physical examination and full-attended in-lab PSG with continuous electrocardiographic signal. The sAA were measured at night before PSG and in the early morning after PSG. Results: The subjects were divided into control [n=26, apnea-hypopnea index (AHI)≤1] and obstructive sleep apnea syndrome (OSAS, n=41, AHI＞1) groups; the OSAS group was subdivided into mild (1＜AHI≤5), moderate (5＜AHI≤10), and severe (10＜AHI) groups. The severe OSAS group was significantly different from the control and other OSAS subgroups in terms of the ratio between the low-and high-frequency components (LF/HF ratio) among the HRV indices. The LF/HF ratio was positively correlated with the sAA ratio and sAA subtraction (r=0.271; r=0.347). Conclusion: TAlthough both HRV and sAA were useful methods of predicting severe OSAS in children, a weak correlation between HRV and sAA was shown in pediatric OSAS subjects. Therefore, HRV and sAA may be independent parameters revealing different aspects of pediatric OSAS.

Local infiltration of dilute solutions of epinephrine is widely used for the purpose of hemostasis during septal surgery. However, infiltrated epinephrine often make several side effects such as palpitation, hypertension, or arrhythmia. Also, it may be possible to experience the catastrophic events such as intracranial hemorrhage, pulmonary edema, and cardiac arrest when we use overdose of epinephrine. We experienced ventricular tachycardia in a 36-year-old male with no significant medical history, after submucosal infiltration of epinephrine with appropriate dose during septoplasty. Intraoperative cardiopulmonary resuscitation by external chest compression and direct current cardioversion was successful. We thoroughly evaluated the patient and proved the diagnosis of variant angina pectoris using coronary angiography.