Comparison of single-breath vital capacity rapid inhalation with sevoflurane 5% and propofol induction on QT interval and haemodynamics for laparoscopic surgery

Şen, Selda; Özmert, Galip; Boran, Nurettin; Turan, Hakan; Çalışkan, Eray

doi:10.1097/00003643-200407000-00007

Cited by 17 publications

(10 citation statements)

References 15 publications

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“…Most studies show that propofol does not significantly affect QTc duration, in adults with 83 or without cardiovascular disease. 60 62 63 74 80 84 The clinical findings are in agreement with experimental results, suggesting that propofol does not affect the QTc interval or the I HERG current. 52 Several investigators have found that propofol may even produce shortening of QT and QTc intervals, 61 63 64 67 85 and that reverses the QTc prolongation induced by sevoflurane.…”

Section: Propofolsupporting

confidence: 72%

“…38 59 Conversely, the single-breath vital capacity method was associated with significant QTc prolongation. 60 Gü ler and colleagues 46 also reported QTd and QTcd increases, but with mean values below 50 ms. Studies on sevoflurane used for both induction and maintenance of anaesthesia showed a significant prolongation of QT 61 and QT c 61 -65 , but no effect on QTd. 66 Moreover, a trend towards a decrease in QTd and QTcd values was described by Kazanci and colleagues.…”

Section: Sevofluranementioning

confidence: 94%

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Impact of anaesthetic drugs and adjuvants on ECG markers of torsadogenicity

Staikou

Stamelos

Stavroulakis

2014

British Journal of Anaesthesia

103

119

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Drug-induced prolongation of cardiac repolarization may trigger malignant ventricular arrhythmias, such as torsade de pointes. The duration of QT interval, QT corrected for heart rate (QTc), JT interval, QT dispersion (QTd), QT variability index, and transmular dispersion of repolarization (TDR) are ECG markers of torsadogenicity. All volatiles, especially isoflurane and desflurane, have been found to prolong QTc and QTcd, while sevoflurane has probably no effects on TDR. Among i.v. anaesthetics, propofol seems superior due to its minimal effects on QTc and TDR; moreover, a decrease in QTc and QTcd has been demonstrated in many studies. Regarding opioids, fentanyl, alfentanil, and remifentanil produce no effects on QTc, while sufentanil, at high doses, may induce QT prolongation. Succinylcholine, but not the non-depolarizing neuromuscular blockers, produces QTc prolongation which can be attenuated by opioids and β-blockers. Reversal of neuromuscular block with anticholinesterase-anticholinergic combinations has been associated with significant QTc prolongation, while such an effect has not been demonstrated for sugammadex, even at high doses. Local anaesthetics have probably no intrinsic action on duration of repolarization; nevertheless, an extensive subarachnoid sympathetic block may increase the duration of QTc. On the contrary, thoracic epidural anaesthesia has been associated with a decrease in both QTc and TDR. Among adjuvants, midazolam seems to have no effect on QTc and TDR, while commonly used antiemetics, such as droperidol, domperidone, and most 5-HT3 antagonists, produce significant QT prolongation. The effects of anaesthetic drugs and techniques on electrocardiographic torsadogenic markers should be considered in the perioperative management of patients with preexisting repolarization abnormalities.

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Section: Propofolsupporting

confidence: 72%

Section: Sevofluranementioning

confidence: 94%

Impact of anaesthetic drugs and adjuvants on ECG markers of torsadogenicity

Staikou

Stamelos

Stavroulakis

2014

British Journal of Anaesthesia

103

119

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“…Studies reporting the effects of propofol on QTc are conflicting, with most studies of healthy patients undergoing anesthesia reporting either no change [85][86][87][88][89][90] or a decrease [91][92][93] in QTc with induction boluses of 1-2.5 mg/kg, but others reporting a statistically significant, albeit clinically insignificant, increase in QTc 93 or TDR 98,100,101 .…”

Section: Intravenous Anesthetic Agentsmentioning

confidence: 99%

“…Almost all volatile anesthetics prolong QTc through the inhibition of potassium membrane currents, primarily I Ks (as opposed to I Kr as in most diLQTS). The effect of sevoflurane on QTc has been the subject of numerous studies, many of which found an increase in QTc [85][86][87][88][89]91,98,[112][113][114][115][116][117][118] and QTcd 112,119 of varying degrees of clinical significance, while others found no significant change 97,100,[120][121][122][123][124][125] . Sevoflurane-associated QTc prolongation may be attenuated by the addition of IV agents 125 , reversed by conversion to propofol 99 , and influenced by the speed of concentration change, favoring gradual over one-breath induction techniques 86,[119][120][121][122] .…”

Section: Inhaled Anesthetic Agentsmentioning

confidence: 99%

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Long QT Syndrome and Perioperative Torsades de Pointes: What the Anesthesiologist Should Know

Niimi

Yuki

Zaleski

2022

Journal of Cardiothoracic and Vascular Anesthesia

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Effects of sevoflurane on QT dispersion and heart rate variability

et al. 2006

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The purpose of this study was to use estimates of corrected QT dispersion (QTcd) and heart rate variability (HRV) to assess the effects of sevoflurane, an inhalation agent used frequently in clinical practice, on autonomic cardiac function. This study was conducted prospectively and in a blind manner on 20 women between 38 and 51 y of age who were classified as American Society of Anesthesiologists stage I-II and whose treatment required total abdominal hysterectomy. Electrocardiograms were recorded by 12-lead Holter monitor for 5 min before sevoflurane induction and again for 5 min at 10 min after tracheal intubation. Data on the first recording were considered as baseline; those on the second recording were viewed as final data. The study was terminated at this point, and surgery was allowed to proceed. QTcd and HRV values were assessed by a cardiologist, who was blinded to all data. All parameters were expressed as a mean value +/- standard deviation. Wilcoxon's test was used to compare baseline and final data. Statistical significance was considered as P<.05. No significant changes were observed between baseline and final QTcd values and between low- and high-frequency components (LF and HF) of HRV; nor were changes seen in the LF/HF ratio. With the patient under sevoflurane/ nitrous oxide anesthesia, no significant changes were detected in QTcd, LF, and HF values, and in the LF/HF ratio, whereas a significant increase (P=.001) was seen in standard deviation of the R-R interval, which was used as a measure of cardiac autonomic tone.

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Comparison of single-breath vital capacity rapid inhalation with sevoflurane 5% and propofol induction on QT interval and haemodynamics for laparoscopic surgery

Cited by 17 publications

References 15 publications

Impact of anaesthetic drugs and adjuvants on ECG markers of torsadogenicity

Impact of anaesthetic drugs and adjuvants on ECG markers of torsadogenicity

Long QT Syndrome and Perioperative Torsades de Pointes: What the Anesthesiologist Should Know

Effects of sevoflurane on QT dispersion and heart rate variability

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