A Comparative Study between Adult and Elderly Patients for the Incidence of Bradycardia Post Creation of Pneumoperitoneum in Patients Undergoing Laproscopic Cholecystectomy

Abstract

Bradycardia occurring post creation of pneumoperitoneum in patients undergoing laproscopic procedures is quite common. The aim of this study is to find out which age groups between the adult and elderly population are more susceptible to bradycardia. 60 patients of age between belonging to ASA grade I and II, scheduled for elective laproscopic cholecystectomy were included in the study. The patients were allocated into two groups of 30 each, Group-A and Group-E. Patients in group-A (Adult) were between age group 18 to 60 years of age Patients in group-E (Elderly) were above 60 years of age Occurrence of bradycardia (heart rate of less the 50/minute) after creation of pneumoperitoneum / gas insufflation was observed in the two groups. Comparison of bradycardia between the two groups revealed higher incidence/occurrence in Elderly group with a p-value of between 0.278 which is statistically insignificant. Bradycardia did not result in intraoperative cardiac arrest, neither did it increase the frequency of intensive care unit admission or mortality rate. Surgery resumed in all cases without adversity. Bradycardia is common occurrence post creation of pneumoperitoneum/ gas insufflation in laproscopic surgeries. It usually arises in response to gas insufflation as a vagal mediated physiologic response, and is benign in the majority of cases. Occurrence of bradycardia was more in elderly patients but did not significantly effect outcome. Deflation of pneumoperitoneum and Atropine administration are effective in reversing Bradycardia and possible avoid progression to cardiac arrest.