Incidence and Risk Factors of Severe Bradycardia During Spinal Anesthesia with Chronic β-Blockade
Journal Title: International Journal of Anesthesiology & Research (IJAR) - Year 2015, Vol 3, Issue 4
Abstract
Background: Severe bradycardia and asystole after spinal anesthesia was considered a serious side effect. Beta (β)-blockers lower blood pressure with decrease resting heart rate and left ventricular function. In this study, we retrospectively recorded the incidence of severe bradycardia and asystole during spinal anesthesia in patients medicated with β-blockers and investigated risk factors contributing to the incidence of severe bradycardia. Methods: Anesthesia chart of 693 cases were retrospectively examined. All patients receive elective surgery in our institute with spinal anesthesia and received β-blockers until the day of operation. Bradycardia was defined as a heart rate <50 beats per minute for at least 1 minute. Ten variables as risk factors contributing to bradycardia were selected: gender, age, body mass index, spinal drug dose, and peak sensory block height, baseline heart rate, baseline systolic blood pressure, baseline diastolic blood pressure, baseline mean blood pressure, and history of diabetes. Results: Eighty six of the 693 (13.4%) patients experienced bradycardia. No asystole occurred. On univariate analysis, male gender, absence of diabetes, low baseline heart rate was associated with statistically higher incidence of bradycardia. In multivariate logistic regression, low baseline heart rate, absence of diabetes elevated the risk of bradycardia (Odds Ratio, 10.44 and 2.6 respectively). Conclusions: The incidence of severe bradycardia during spinal anesthesia was 13.4% in the patient receiving the β-blockers. Those with low baseline heart rate and absence of diabetes were more vulnerable to develop severe bradycardia.
Authors and Affiliations
Jae Ho Lee
Keywords
Related Articles
- EP ID EP202297
- DOI 10.19070/2332-2780-1500027
- Views 103
- Downloads 0
Paravertebral Block: A Comparative Study Evaluating Performance of Direct Surgical And Classic Technique
Introduction: Thoracic paravertebral block (TPVB) has been employed for post operative analgesia in thoracotomy. Paravertebral block can be given by various techniques, two most commonly used techniques include direct su...
Comparative Study of Epidural Dexmedetomidine and Magnesium Sulphate used as Adjuvant to Ropivacaine for Post-Operative Analgesia in Thoracotomy
Background: Dexmedetomidine is the selective 2-adrenoceptor agonist with analgesic potency. Magnesium has antinociceptive effects in animal and human models of pain. Our hypothesis was that the addition of magnesium and...
Near-Infrared Spectroscopy Does Not Reliably Detect the Cerebral Status in Adults During Aortic Arch Surgery - A Retrospective Trial
Introduction: To investigate relationship between intraoperative regional oxygen cerebral desaturation (rScO2) and the incidence of neurological deficit after aortic arch surgery in adult patients. Methods: This study w...
Anesthetic Management of a Patient with Polycythemia Vera for Nephrectomy
Polycythemia Vera (PV) is a chronic myeloproliferative disease, characterized by erythrocytosis and hyperviscosity. A high proportion of PV surgeries are complicated by thrombosis (7.7%) or by a major hemorrhage (7.3%),...
Percutaneous Dilatational Tracheostomy: ULTRAperc® Single Stage Dilator Technique Versus Ciaglia Blue Dolphin® Balloon Dilatation Technique for Intubated Unweanable ICU Patients
Background: Percutaneous tracheostomy is currently one of the most common procedures performed in ICU. It has demonestrated provide numerous advantages over the classical surgical tracheostomy. The aim of this study is t...