Reflex bradycardia in out-patient surgery done under local anesthesia

Summary

Reflex bradycardia is an abnormal reaction to certain stimuli causing a sustained drop in pulse rate; it responds promptly to the administration of atropine. Arrhythmia, fall in blood pressure and oxygen saturation may also occur. If not treated promptly, the condition may be fatal. From 432 consecutive plastic surgical patients operated under local anesthesia at a surgical day care clinic, 12 developed reflex bradycardia (2.8%). The mean drop in pulse rate was 30%. In addition, four patients had arrhythmia. After administration of atropine, the symptoms disappeared in all patients. Since procedures under local anesthesia are frequently done in the plastic surgery office and an anesthetist is not always present, one should be aware and prepared for this potentially dangerous complication.