ASSOCIATION OF DEXMEDETOMIDINE USE WITH INTRAOPERATIVE BRADYCARDIA: A CASE-CONTROL STUDY IN SURGICAL PATIENTS AT A TERTIARY HOSPITAL IN DEHRADUN
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Keywords
Dexmedetomidine, Intraoperative bradycardia, Cardiovascular complications, Risk factors, Indian surgical population
Abstract
Background: Dexmedetomidine, an alpha-2 adrenergic agonist, is increasingly used in perioperative settings for its sedative and analgesic properties. However, its association with bradycardia remains a significant clinical concern, particularly in the Indian healthcare context where cardiovascular complications can impact surgical outcomes.
Objectives: To determine the association between dexmedetomidine use and intraoperative bradycardia in surgical patients and identify risk factors in a tertiary care setting in Dehradun, India.
Methodology: A retrospective case-control study was conducted from September 2019 to December 2020 at a tertiary hospital in Dehradun. Cases (n=180) were patients who developed intraoperative bradycardia (heart rate <60 bpm), and controls (n=180) were matched patients without bradycardia. Data on dexmedetomidine exposure, patient demographics, and surgical variables were analyzed using logistic regression.
Results: Dexmedetomidine use was significantly associated with intraoperative bradycardia (OR: 3.42, 95% CI: 2.18-5.37, p<0.001). The incidence of bradycardia was 23.8% in the dexmedetomidine group versus 8.1% in controls. Age >65 years (OR: 2.15) and ASA grade ≥III (OR: 1.87) were additional risk factors.
Conclusion: Dexmedetomidine use significantly increases the risk of intraoperative bradycardia. Careful monitoring and dose optimization are recommended, especially in elderly patients and those with higher ASA grades in the Indian surgical population.
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Dr. Shah Parth Rohitkumar
Assistant Professor, Department of Anaesthesiology, SGRRIM&HS, Dehradun, India
Dr. Arunkumar Rameshwarprasad Varun
Associate Professor, Department of Community Medicine, Rama Medical College Hospital & Research Centre, Rama city Delhi- Hapur, Pilkhuwa (U.P.)
Dr shivanand gundalli
Associate Professor Department Of Pathology MMIS Mulana