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Reflex bradycardia during surgery.

D J Doyle1, P W Mark

  • 1Department of Anaesthesia, Toronto General Hospital, Ontario.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|March 1, 1990
PubMed
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Surgical procedures can cause reflex bradycardia and sinus arrest, often due to vagal nerve stimulation. Anticholinergic premedication effectively prevents these cardiac events during surgery.

Area of Science:

  • Anesthesiology
  • Cardiology
  • Surgical Medicine

Background:

  • Reflex bradycardia and sinus arrest are potential complications during various surgical procedures.
  • Vagal-mediated reflexes are frequently implicated, but direct experimental evidence is often limited.
  • Certain anesthetic agents and muscle relaxants may increase the risk of these cardiac events.

Purpose of the Study:

  • To summarize the occurrence and potential mechanisms of reflex bradycardia and sinus arrest in surgery.
  • To identify predisposing factors and effective preventive strategies for these surgical complications.

Main Methods:

  • Review of surgical literature identifying instances of reflex bradycardia and sinus arrest.
  • Analysis of implicated mechanisms, focusing on vagal nerve involvement.

Related Experiment Videos

  • Evaluation of pharmacological agents and premedication strategies.

    • Main Results:

    • These cardiac events can occur across a wide range of surgical specialties, including neurosurgery, general abdominal, laparoscopic, ophthalmic, and facial procedures.
    • Conditions like liver biopsies and electroconvulsive therapy are also associated with these risks.
    • Drugs such as vecuronium, atracurium, halothane, fentanyl, and succinylcholine may contribute to the reflex.
    • Anticholinergic premedication has demonstrated effectiveness in preventing these occurrences.

    Conclusions:

    • Reflex bradycardia and sinus arrest are recognized risks in diverse surgical settings.
    • While vagal mediation is often suspected, further research may be needed for definitive support.
    • Anticholinergic premedication is a reliable method for mitigating the risk of these potentially serious cardiac events during surgery.