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Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults

Older adults exhibit reduced physiological responses to beta-adrenergic stimulation and parasympathetic inhibition. This study aimed to investigate the effect of reducing the incidence of bradycardia in the atropine and ephedrine pretreatment group compared to the control group in older adults who r...

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Autores principales: Kang, Seyoon, Chae, Yun Jeong, Park, Sun Kyung, Kim, Taek Geun, Joe, Han Bum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657617/
https://www.ncbi.nlm.nih.gov/pubmed/36362576
http://dx.doi.org/10.3390/jcm11216349
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author Kang, Seyoon
Chae, Yun Jeong
Park, Sun Kyung
Kim, Taek Geun
Joe, Han Bum
author_facet Kang, Seyoon
Chae, Yun Jeong
Park, Sun Kyung
Kim, Taek Geun
Joe, Han Bum
author_sort Kang, Seyoon
collection PubMed
description Older adults exhibit reduced physiological responses to beta-adrenergic stimulation and parasympathetic inhibition. This study aimed to investigate the effect of reducing the incidence of bradycardia in the atropine and ephedrine pretreatment group compared to the control group in older adults who received spinal anesthesia with intravenous dexmedetomidine. Overall, 102 older adults aged over 65 years were randomly divided into three groups, and saline (control group), atropine at 0.5 mg (atropine group), and ephedrine at 8 mg (ephedrine group) were administered intravenously to each group as pretreatment. Immediately after spinal anesthesia, dexmedetomidine loading and study drug injections were commenced. The primary outcome was the incidence of bradycardia (<50 beats per min) within 60 min following dexmedetomidine loading. The incidence of bradycardia requiring atropine treatment was significantly higher in the control group than in the atropine and ephedrine groups (27.3% vs. 6.1% and 8.8%, respectively; p = 0.035), and no difference was noted between the atropine and ephedrine groups. Therefore, if ephedrine or atropine is selected and used according to the patient’s condition and clinical situation, it may be helpful in preventing bradycardia during spinal anesthesia using dexmedetomidine in older patients.
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spelling pubmed-96576172022-11-15 Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults Kang, Seyoon Chae, Yun Jeong Park, Sun Kyung Kim, Taek Geun Joe, Han Bum J Clin Med Article Older adults exhibit reduced physiological responses to beta-adrenergic stimulation and parasympathetic inhibition. This study aimed to investigate the effect of reducing the incidence of bradycardia in the atropine and ephedrine pretreatment group compared to the control group in older adults who received spinal anesthesia with intravenous dexmedetomidine. Overall, 102 older adults aged over 65 years were randomly divided into three groups, and saline (control group), atropine at 0.5 mg (atropine group), and ephedrine at 8 mg (ephedrine group) were administered intravenously to each group as pretreatment. Immediately after spinal anesthesia, dexmedetomidine loading and study drug injections were commenced. The primary outcome was the incidence of bradycardia (<50 beats per min) within 60 min following dexmedetomidine loading. The incidence of bradycardia requiring atropine treatment was significantly higher in the control group than in the atropine and ephedrine groups (27.3% vs. 6.1% and 8.8%, respectively; p = 0.035), and no difference was noted between the atropine and ephedrine groups. Therefore, if ephedrine or atropine is selected and used according to the patient’s condition and clinical situation, it may be helpful in preventing bradycardia during spinal anesthesia using dexmedetomidine in older patients. MDPI 2022-10-27 /pmc/articles/PMC9657617/ /pubmed/36362576 http://dx.doi.org/10.3390/jcm11216349 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kang, Seyoon
Chae, Yun Jeong
Park, Sun Kyung
Kim, Taek Geun
Joe, Han Bum
Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title_full Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title_fullStr Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title_full_unstemmed Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title_short Prevention of Bradycardia during Spinal Anesthesia under Dexmedetomidine Sedation in Older Adults
title_sort prevention of bradycardia during spinal anesthesia under dexmedetomidine sedation in older adults
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657617/
https://www.ncbi.nlm.nih.gov/pubmed/36362576
http://dx.doi.org/10.3390/jcm11216349
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