ECG variations in patients pre- and post-local anaesthesia and analgesia

Hill, C. M.; Mostafa, Pashang Seyyed; Stuart, Graham; Thomas, David W.; Walker, Rachael

doi:10.1038/sj.bdj.2009.978

Cited by 11 publications

(7 citation statements)

References 13 publications

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“…In this study, QRS complex abnormalities predominated, with the RSR pattern being the most frequently reported single ECG abnormal sign (21.4%) and tachycardia coming in at 17.4%. Similar to the incidence range variation, abnormalities showed variation regarding the most commonly reported abnormality; Hill et al (2009) reported that the RSR pattern was the most common abnormality seen in patients who underwent teeth extraction under local anaesthesia and analgesia [ 21 ], in consensus with the present study. However, Asadi et al (2019) showed that the most common ECG abnormalities included inverted T-waves (21.2%) and sinus tachycardia (11.7%) [ 6 ].…”

Section: Discussionsupporting

confidence: 85%

Preoperative ECG Abnormalities Among Patients Who Underwent Elective Surgical Operations at the Kuwaiti Specialised Hospital, Khartoum, Sudan: A Cross-Sectional Study

Ahmed,

Abdalla

et al. 2024

Cureus

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Background: The presence of preoperative ECG abnormalities has shown wide variation, and its value has been argued; thus, this study aimed to determine preoperative ECG abnormalities among Sudanese patients and their correlates. Materials and methods: An observational descriptive cross-sectional study was conducted at the Kuwaiti Specialised Hospital, Khartoum, Sudan, from October 2020 to March 2021, including all patients over 40 years of age who planned to undergo elective surgery. Demographic, clinical, and ECG findings were obtained during the pre-anaesthesia check-up. The data were analysed using IBM SPSS software version 28 (IBM Corp., Armonk, NY). Results: The study included a total of 304 patients with a mean age of 60±14 years, a male predominance of 210 (69.1%) patients, the presence of hypertension (HTN) in 65 (21.4%), and diabetes mellitus (DM) in 58 (19.1%) patients. The study showed that 235 (77%) patients had at least one ECG abnormality. However, 62 (20.4%) were diagnosed as having normal ECG variations; the most commonly diagnosed abnormality was ischemic heart disease (IHD) (32.5%), followed by sinus tachycardia (39, 12.8%). The QRS complex abnormalities were the most common (100, 32.9%), with M-shaped QRS (RSR pattern) being the most common single ECG abnormal sign (65, 21.4%). The ECG abnormalities showed no significant association with age (p-value = 0.24), gender (p-value = 0.16), DM (p-value = 0.77), HTN (p-value = 0.35), asthma (p-value = 0.35), or the grade of surgery (p-value = 0.52). However, the diagnosis of IHD was associated with the presence of HTN (p-value = 0.001). Conclusion: Incidental preoperative ECG abnormalities are common among Sudanese patients undergoing elective surgery, affecting more than three-quarters of them and being of diagnostic value as they led to the diagnosis of ischemic heart disease in nearly one-third of patients. Hypertensive patients may benefit from routine preoperative ECG testing, as ECG signs of ischemic heart disease are more common among hypertensive patients.

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Section: Discussionsupporting

confidence: 85%

Preoperative ECG Abnormalities Among Patients Who Underwent Elective Surgical Operations at the Kuwaiti Specialised Hospital, Khartoum, Sudan: A Cross-Sectional Study

Ahmed,

Abdalla

et al. 2024

Cureus

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“…Moreover, anesthetic agents could have contributed to some of the differences between ECG results of the present study, compared with other species, because, for instance, humans, cats, and dogs are not generally anesthetized for ECG. It has been suggested that general anesthesia influences cardiac rhythm and the durations of the ST-T segment, QT interval, and QT interval corrected for heart rate [68][69][70] ; however, without knowing the direct impact of the various anesthetic protocols on the ECG results for the chimpanzees in the present study, it was impossible to speculate on this issue further.…”

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confidence: 63%

Evaluation of relationships between results of electrocardiography and echocardiography in 341 chimpanzees (Pan troglodytes)

Drane

Atencia

Cooper

et al. 2020

ajvr

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OBJECTIVETo examine potential relationships between ECG characteristics and echocardiographic measures of cardiac structure in chimpanzees (Pan troglodytes). ANIMALS341 chimpanzees (175 males and 166 females) from 5 sanctuaries and 2 zoological collections. PROCEDURESChimpanzees were anesthetized for routine health examinations between May 2011 and July 2017 as part of the International Primate Heart Project and, during the same anesthetic events, underwent 12-lead ECG and transthoracic echocardiographic assessments. Relationships between results for ECG and those for echocardiographic measures of atrial areas, left ventricular internal diameter in diastole (LVIDd), and mean left ventricular wall thicknesses (MLVWT) were assessed with correlational analysis, then multiple linear regression analyses were used to create hierarchical models to predict cardiac structure from ECG findings. RESULTSFindings indicated correlations (r = -0.231 to 0.310) between results for ECG variables and echocardiographic measures. The duration and amplitude of P waves in lead II had the strongest correlations with atrial areas. The Sokolow-Lyon criteria, QRS-complex duration, and R-wave amplitude in leads V 6 and II had the strongest correlations with MLVWT, whereas the Sokolow-Lyon criteria, QRS-complex duration, and S-wave amplitude in leads V 2 and V 1 had the strongest correlations with LVIDd. However, the ECG predictive models that were generated only accounted for 17%, 7%, 11%, and 8% of the variance in the right atrial end-systolic area, left atrial end-systolic area, MLVWT, and LVIDd, respectively.

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“…5,6 A Brugada electrocardiogram pattern may be induced by several drugs. 12 No case of inferior ST-elevation resembling a Brugadalike pattern after administration of pregabalin and quetiapine, however, has been reported so far. Tricyclic antidepressants may elicit a Brugada electrocardiographic pattern.…”

Section: Discussionmentioning

confidence: 99%

Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

Brunetti

Ieva²,

Correale³

et al. 2016

American Journal of Therapeutics

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The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.

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ECG variations in patients pre- and post-local anaesthesia and analgesia

Cited by 11 publications

References 13 publications

Preoperative ECG Abnormalities Among Patients Who Underwent Elective Surgical Operations at the Kuwaiti Specialised Hospital, Khartoum, Sudan: A Cross-Sectional Study

Preoperative ECG Abnormalities Among Patients Who Underwent Elective Surgical Operations at the Kuwaiti Specialised Hospital, Khartoum, Sudan: A Cross-Sectional Study

Evaluation of relationships between results of electrocardiography and echocardiography in 341 chimpanzees (Pan troglodytes)

Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

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