Ephedrine Is More Effective Than Atropine for the Treatment of Symptomatic Bradycardia in Elderly Patients

Abstract

Background: Bradycardia may result in the exacerbation of myocardial dysfunction in elderly patients. Objectives: In this retrospective cohort study, ephedrine and atropine were compared for the treatment of symptomatic bradycardia. Methods: In this study, patients (above 65 years) with symptomatic bradycardia during skin tumor resection were evaluated. Symptomatic bradycardia was defined as heart rate below 49 beats per minute and systolic blood pressure below 85 mmHg. According to the anesthesiologist's decision, 1 group of patients (atropine group) received atropine (0.5 mg) as the first-line drug, while the other group (ephedrine group) received ephedrine (10 mg) as the first-line drug to restore hemodynamic parameters. If the initial treatment had no effects on the management of the symptoms, ephedrine (10 mg) was administered to the patients in both groups. The number of patients, who received treatment with a single drug to normalize their hemodynamic parameters, was compared with those who required a second drug. Results: Among 194 subjects with symptomatic bradycardia, 86 and 108 patients were allocated to the atropine and ephedrine groups, respectively. Based on the findings, 35 patients in the atropine group required the second drug for bradycardia management; therefore, 51 patients were treated with only atropine (efficacy: 51/86, 59.30%). Moreover, 21 patients in the ephedrine group required the second dose of ephedrine for the management of bradycardia; consequently, 87 patients were treated with only ephedrine (efficacy: 87/108, 80.55%). There was a statistically significant difference between the 2 groups (P = 0.001). Conclusions: Ephedrine is more effective than atropine in the management of symptomatic bradycardia in elderly patients.

Nephrolithotripsy Surgery Using Spinal Anesthesia Method: a Comparison in Hemodynamic Changes between the Patients Injected Atropine and Ephedrine

“…However, this increase in heart rate in the atropine group was observed at all minutes up to 25 except for 10. Shahriari & Khooshideh (2017) investigated ephedrine and atropine in preventing bradycardia in elderly patients undergoing skin tumor resection, whereby the effect of ephedrine was reported to be greater than atropine in managing symptomatic bradycardia. In the present study, again ephedrine had developed a balanced heart rate without fluctuation in most minutes in patients.…”