There is limited evidence to date regarding pharmacological interventions used for the management of bradycardia in acute SCI. Only one study was found which investigated enteral albuterol as treatment for bradycardia in acute SCI patients. However, the effectiveness of other pharmacological agents (aminophylline and theophylline) for acute bradycardia post SCI has been studied in case report format (Pasnoori & Leesar, 2004; Sadaka et al. 2010; Schulz-Stubner, 2005; Whitman et al. 2008).
There has been one study to investigate the effectiveness of enteral albuterol for treatment of bradycardia during acute SCI. Evans et al. (2014) conducted a case control study in which 18 patients with cervical SCI were retrospectively reviewed; 8 patients who were treated with enteral albuterol during hospitalization following injury were compared to 10 patients not given this treatment. One hundred percent of patients developed bradycardia, however the median of bradycardic episodes was significantly lower (1.8) in patients receiving albuterol compared to patients not receiving albuterol (4.3; p=0.08). The authors also noted that the median total of atropine administered was significantly lower in patients given albuterol (0 mg) than in patients not given albuterol (1 mg; p=0.013).
There is level 3 evidence (from one case control; Evans et al. 2014) that enteral albuterol reduces bradycardic episodes in acute SCI patients.
Enteral albuterol may be effective for the management of bradycardia during the acute phase post SCI.