The correlation of heart rate between natural sleep and dexmedetomidine sedation

Abstract

Background Sedation by dexmedetomidine, like natural sleep, often causes bradycardia. We explored the nature of heart rate (HR) changes as they occur during natural sleep versus those occurring during dexmedetomidine sedation. Methods The present study included 30 patients who were scheduled to undergo elective surgery with spinal anesthesia. To assess HR and sedation, a pulse oximeter and bispectral index (BIS) monitor were attached to the patient in the ward and the operating room. After measuring HR and BIS at baseline, as the patients slept and once their BIS was below 70, HR and BIS were measured at 5-minute intervals during sleep. Baseline HR and BIS were also recorded before spinal anesthesia measured at 5-minute intervals after dexmedetomidine injection. Results During natural sleep, HR changes ranged from 2 to 19 beats/min (13.4 ± 4.4 beats/min), while in dexmedetomidine sedation, HR ranged from 9 to 40 beats/min (25.4 ± 8.5 beats/min). Decrease in HR was significantly correlated between natural sleep and dexmedetomidine sedation (R 2 = 0.41, P < 0.001). The lowest HR was reached in 66 min during natural sleep (59 beats/min) and in 13 min with dexmedetomidine sedation (55 beats/min). The time to reach minimum HR was significantly different (P < 0.001), but there was no difference in the lowest HR obtained (P = 0.09). Conclusions There was a correlation between the change in HR during natural sleep and dexmedetomidine sedation. The bradycardia that occurs when using dexmedetomidine may be a normal physiologic change, that can be monitored rather than corrected.

The Effect of Continuous Field Block through Intercostal Muscles after Atrial Septal Defect Closure via a Mini-Right Thoracotomy in Pediatric Patients

“…There was no significant difference in the post-operative heart rate between the Single and Continuous groups, because the continuous dexmedetomidine infusion reduced the heart rate in both groups. Earlier studies demonstrated the heart rates were lower in patients who received a dexmedetomidine infusion [7][8][9] . In contrast, the pain management due to the continuous field block in the present study reduced the respiratory rate in the Continuous group.…”

The correlation between the STOP-Bang score and oxygen saturation during spinal anesthesia with dexmedetomidine sedation

“…Dexmedetomidine, a selective α 2 adrenergic receptor agonist, has sedative and analgesic properties. Its sedation is similar to that of natural sleep; therefore, it is known to cause less respiratory depression [ 15 ]. However, the advantage of being similar to natural sleep implies that the incidence rate of OSA is high, as reported by Shin et al [ 16 ].…”

Dexmedetomidine: What’s New for Pediatrics? A Narrative Review

“…The DEX-induced bradycardia has, to date, not been reported to be of clinical relevance or require pharmacologic treatment. In adults, the drop in heart rate during DEX sedation mimics the heart rate response observed during natural and DEX-induced sleep in adults: Natural and DEX-induced sleep demonstrated changes in heart rate that were not statistically different [ 49 ]. Further studies will be important to determine whether, similar to adults, the heart rate response to DEX in the pediatric population is similar to those observed during natural sleep.…”