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Bradycardia During Laparoscopic Surgeries: A Retrospective Cohort Study

  • Inbal Dabush-Elisha
  • Or Goren
  • Aviram Herscovici
  • Idit MatotEmail author
Original Scientific Report
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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 CO2 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.

Abbreviations

AIMS

Anesthesia Information Management System

ASA

American Society of Anesthesiologists physical status classification system

BP

Blood pressure

ICU

Intensive care unit

Notes

Compliance with ethical standards

Ethical approval

Ethical approval for this study (Ethical Committee No. 0173-13-TLV) was provided by the Ethical Committee of the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Chairperson Prof. Marcel Topilsky) on May 23, 2013.

Informed consent

Informed consent was waived by the ethical committee.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Inbal Dabush-Elisha
    • 1
  • Or Goren
    • 2
  • Aviram Herscovici
    • 3
  • Idit Matot
    • 4
    Email author
  1. 1.Department of AnesthesiologyWolfson Medical CenterHolonIsrael
  2. 2.Division of Anesthesiology and Intensive Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Division of Anesthesiology and Intensive Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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