• Hyo-Jin Kim and EunJin Ahn.
• Department of Anesthesiology & Pain Medicine, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Gwangmyeong, Republic of Korea.
• Medicine (Baltimore). 2022 Oct 28; 101 (43): e31306e31306.

AbstractSedation with dexmedetomidine is needed for patients undergoing spinal anesthesia. However, dexmedetomidine sedation increases the incidence of bradycardia. We aimed to identify and to evaluate risk factors for bradycardia in patients undergoing spinal anesthesia with dexmedetomidine sedation. The records of 91 patients who underwent spinal anesthesia with sedation using dexmedetomidine were reviewed retrospectively. For this study, we identified 15 characteristics of included patients from this group who underwent lower leg surgery and had an estimated blood loss of <300 mL. We collected details on potential risk factors for bradycardia from their clinical records. These factors included age, American Society of Anesthesiologists classification, height, weight, sensory level of spinal anesthesia, history of hypertension, diabetes mellitus, loading, and maintenance dose of dexmedetomidine, tourniquet time, initial diastolic and systolic blood pressure, initial heart rate (HR), and anesthesia and surgery duration. The primary endpoint of this study was the occurrence of bradycardia. We identified potential risk factors using logistic regression analysis. The incidence of bradycardia was obtained in 23 (25%) of 91 patients. Initial HR and tourniquet time were significant individual predictive factors for the occurrence of bradycardia. Logistic regression analysis showed that adjusted baseline HR and duration of tourniquet use were risk factors for bradycardia. Patients should be monitored when undergoing spinal anesthesia with sedation using dexmedetomidine for bradycardia when they have a long tourniquet time. A low initial HR could also be a predictive factor for bradycardia.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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