The investigation of the incidence rate of bradycardia caused by nasopharynx irritation and its related factors in adenoidectomy surgery

Background
Adenoidectomy is the most common way to stimulate the vagus nerve, and ultimately bradycardia.

Objectives
The aim of this study was to determine the incidence rate of bradycardia caused by nasopharynx irritation and its related factors in patients undergoing adenoidectomy surgery.

Material and methods
The current study is a descriptive-analytic cross-sectional study. 142 children under adenoidectomy surgery enter the study in 2017. Demographic data, hemoglobin, echocardiography, SpO2, heart rate of patient before and after anesthesia and during and after surgery, duration of surgery, use or non-use of atropine and its amount were collected. Sampling was carried out using the sequential non-probabilistic method. SPSS version 22 was used to analyze the data.

Results
The average age was 3.1 years. The rate of bradycardia among 1 to 2-year-old patients was 38.8% (14 patients) and among 2 to 6-year-old patients it was 12.4% (13 patients). The results of 1 to 2-year-old patients showed a significant relationship between bradycardia and age. The results of 2 to 6-year-old patients showed a decrease in bradycardia as age increases to 6 years. There was a significant relationship between bradycardia and SpO2 rate at the ages of 1 to 2 years and 2 to 6 years. With bradycardia, the patient SpO2 dropped. There was a significant relationship between bradycardia and duration of surgery, and also atropine use.

Conclusions
Due to the occurrence of early bradycardia in early ages in adenoidectomy and the possibility of affecting the cardiac output, more precision during this surgery by anesthesiologists and surgeons leads to a reduction in adverse bradycardia effects on the heart.