Factors influencing intraoperative bradycardia in adult patients.
OBJECTIVE
In order to elucidate the prominent factors involved in intraoperative bradycardia in adult patients, we retrospectively investigated the association between the potential risk factors and intraoperative bradycardia, using multiple logistic regression.


METHODS
The perioperative records for 499 adult patients who had undergone any of six elective surgeries were retrospectively examined. The potential factors included patient characteristics, the use of perioperative drugs for anesthesia, and the types of operational procedures. Heart rates were extracted at five points perioperatively. The frequencies and total doses of atropine injections to treat bradycardia were examined. Simple and multiple logistic regressions were used to analyze the relative risk factors for a intraoperative bradycardia.


RESULTS
The multiple logistic regression analysis revealed that the absence of atropine premedication was the most prominent risk factor for bradycardia (odds ratio; 1.86-5.51) from arrival in the operating room until the end of the operation. Other prominent factors, whose effects were only temporary, were as follows. Males had a higher risk of bradycardia than females upon arrival in the operating room. Surgical procedures with an epidural or subarachnoid blockade tended to have a higher risk for bradycardia after the operation. Propofol induction had a greater risk for bradycardia than thiopental after the end of the operation. Endotracheal intubation had a lower risk for bradycardia than no endotracheal intubation after induction. Vecuronium tended to induce bradycardia after operation.


CONCLUSIONS
The most prominent factor affecting heart rate was atropine premedication. It was noteworthy that a single preoperative administration of atropine affected heart rate throughout the operation.
Yorozu
Tomoko
T
Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Iijima
Takehiko
T
Matsumoto
Midori
M
Yeo
Xing
X
Takagi
Toshiyuki
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000627:therapeutic use; D001919:Bradycardia / Q000453:epidemiology / Q000503:physiopathology*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010276:Parasympatholytics / Q000627:therapeutic use; D011292:Premedication; D012189:Retrospective Studies
D010276:Parasympatholytics; D001285:Atropine