Background and aims Perioperative cardiac arrhythmias are undesirable events leading to cardiovascular instability. This study was to determine the incidence and factors associated with cardiac arrhythmias during perioperative period in orthopedic surgery.
Methods The study was a retrospective cohort study approved by the ethical committee of the faculty of medicine, Chiang Mai University. Data of patients undergoing orthopedic surgery were prospectively collected from 1 January 2016 to 31 December 2017.Details of cardiac arrhythmias described in the case record form were independently reviewed by two anesthesiologists. The univariable and logistic regression analyses were used to determine factors associated with the cardiac arrhythmias at the statistically significant level of 0.05, by the SPSS software version 22.0.
Results Arrhythmias occurred in 56 out of 7158 orthopedic surgical patients (0.8%).Bradycardia was the most common type (80.4%) followed by PVCs (14.3%).The occurrences of cardiac arrhythmias in patients receiving general anesthesia (GA), neuraxial anesthesia, and peripheral nerve blocks were 1.1% (38/3369), 0.6%(16/2645) and 0.6% (7/1144); respectively. From the univariate analysis, factors associated with the arrhythmias were age >45 years (p=.018), ASA >2 (p=.008) and GA (.002). After the multiple variable logistic regression analysis, factors significantly associated with the arrhythmias were age >45 years and general anesthesia.
Conclusions Bradycardia was the most common type during orthopedic surgery. Advanced age and general anesthesia were the associated risk factors. The findings indicate that regional anesthesia could be more advantageous, particularly for those who are at high risk. Despite increased risk, general anesthesia is indicated in some situations where anesthesia should be optimized and carefully monitored.
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