Bradycardia During Laparoscopic Surgeries: A Retrospective Cohort Study

Inbal Dabush-Elisha, Or Goren, Aviram Herscovici, Idit Matot

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. Methods: Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, between June 2008 and August 2013 at a tertiary, academic medical center, were screened for intraoperative bradycardia (heart rate <50 beats/min for at least three consecutive measures). Results: Intraoperative bradycardia occurred in 1540 (15.5%) patients, in the majority (945, 61.3%) heart rate decreased to <45 beats/min. Mean (SD) duration of bradycardia was 14.8 (16.8) min. Bradycardia was more prevalent in males, older patients, smokers, patients with comorbidities and those treated with β, α and calcium channel blockers. The majority of events were related to CO 2 insufflation and bolus opioid administration. In 1343 (87%), noteworthy decreases in blood pressure were recorded; the average (SD) drop in systolic blood pressure was 35 (21) mmHg. Pharmacological intervention to alleviate bradycardia was used in up to 23% of episodes. Bradycardia did not result in intraoperative cardiac arrest, neither did it increase the frequency of intensive care unit admission or mortality rate. Conclusion: Bradycardia is common during laparoscopy. Despite being more prevalent in older and sicker patients, bradycardia did not significantly affect outcome, suggesting that routine preventive measures do not need to be implemented. Rather, intraoperative bradycardia events should be wisely followed with prompt response, when hemodynamic perturbations occur, the threshold of which is yet to be defined.

Original languageEnglish
Pages (from-to)1490-1496
Number of pages7
JournalWorld Journal of Surgery
Volume43
Issue number6
DOIs
StatePublished - 15 Jun 2019
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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