Effects of remifentanil,nitroglycerin, and sevoflurane on the corrected QT and Tp-e intervals during controlled hypotensive anesthesia |
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| Institution: | 1. Department of Anesthesiology, Dr. Sami Ulus Maternity and Children''s Research and Education Hospital, Ankara, Turkey;2. Department of Anesthesiology, Turgut Ozal University Hospital, Ankara, Turkey;3. Department of Cardiology, D??kap? Y?ld?r?m Beyaz?t Education and Research Hospital, Ankara, Turkey;1. Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, NO 45 Chang Chun Road, Xi Cheng District, Beijing 100053, P. R. China;2. Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI 48201, USA;1. Department of Pharmacy Services, Medical University of South Carolina, 150 Ashley Avenue, MSC 584, Charleston, SC, 29425, USA;2. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, 167 Ashley Avenue, Suite 301, MSC 912, Charleston, SC, 29425-9120, USA;3. Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Suite 303, MSC 835, Charleston, SC, 29425, USA;1. Department of Anesthesiology, Lourdes Hospital, Ernakulam, Kochi, Kerala 682012, India;2. Department of Neurosurgery, Lourdes Hospital, Ernakulam, Kochi, Kerala 682012, India;1. Department of Anesthesia, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai 201399, China;2. Department of General Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai 201399, China;1. Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;2. Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea |
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| Abstract: | Study objectiveControlled hypotension is a preferred method in various surgical operations, but limited data are available for the effects of drug combinations that are used to ensure the desired level of hypotension on cardiac repolarization.DesignRandomized, prospective, double-blinded study.PatientsThe study comprised 65 patients undergoing septorhinoplasty surgery under general anesthesia.InterventionsGroup S received sevoflurane inhalation alone, group R received sevoflurane and remifentanil, and group N received sevoflurane and nitroglycerine in a way that a mean arterial pressure of 60 ± 5 mm Hg was achieved.MeasurementsElectrocardiogram was performed before induction (T1), 30 minutes after induction (T2), and 5 minutes after extubation (T3). Corrected QT (QTc), QT dispersion (QTd), and corrected Tp-e (Tp-ec) intervals and Tp-e/corrected QT (Tp-e/QTc) ratio were calculated.Main resultsQTc prolongation was observed at T2 and T3 in all groups, but only QTc prolongation at T2 was statistically significant in group S (P> .05). Significant prolongation of QTd interval at T2 and T3 was observed in group S (P< .05). In all groups, Tp-ec decreased at T2. However Tp-ec decrease was not statistically significant in group S (P= .103) and group R (P= .058). Tp-e/QTc was significantly decreased on T2 in all 3 groups, and it was returned to baseline at T3 (P< .05).ConclusionThe present study demonstrated that none of the 3 hypotensive anesthesia methods has an overall negative effect on Tp-e and Tp-e/QTc. Therefore, we conclude that all 3 methods can be used safely in terms of proarrhythmic risk, but increased sevoflurane consumption may require more attention due to significant prolongation of QTc and QTd. |
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