Effects of different concentrations of desflurane on the index of cardiac electrophysiological balance in gynecologic surgery patients

Abstract

The objectives were to observe the effects of different concentrations of desflurane on QT, QTc, Tp-e, Tp-e/QT, and the index of cardiac electrophysiological balance (iCEB). Sixty patients were randomly divided into group D1, group D2, and group D3 by using a random number table, 20 in each group. After entering the operating room, patients received 10 mL/kg hydroxyethyl starch, 0.1 mg/kg midazolam, 0.1 mg/kg vecuronium, 3 μg/kg fentanyl, and 0.3 mg/kg etomidate intravenously and then accepted intubation and mechanical ventilation. The desflurane evaporator was opened. The concentrations of desflurane in the D1, D2, and D3 groups were maintained at 0.6, 1.3, and 2.0 minimum alveolar concentration (MAC), respectively. Twelve-lead ECGs were recorded at time before induction (T1) and at 20 min after desflurane reached the required concentration (T2). HR and MAP were recorded measure and the QT interval, QTc interval, Tp-e interval, Tp-e/QT ratio, and iCEB were calculated. Compared with before inhalation (T1), the QTc interval was prolonged in the D1, D2, and D3 groups after inhalation of different concentrations of desflurane for 20 min (T2) (P < 0.05) and the Tp-e/QT ratio decreased in the D1 and D2 groups at T2 (P < 0.05). Compared with the D1 and D2 groups, the Tp-e/QT ratio of the D3 group increased at T2 (P < 0.05). There was no significant difference in Tp-e interval and iCEB at any time (P > 0.05). The study suggested that inhalation of desflurane at a normal concentration cannot cause arrhythmogenic characteristics and affect the cardiac electrophysiological stability.

Decompressive Craniectomy Improves QTc Interval in Traumatic Brain Injury Patients

“…The use of some medications, such as β-blockers or β 1 -and β 2 -adrenoreceptor agonists, increases iCEB [14,15]. Importantly, anesthesia with desflurane does not affect the iCEB [39]. In the present study the mean iCEB value oscillated around 4.…”

Effects of dexmedetomidine on cardiac electrophysiology in patients undergoing general anesthesia during perioperative period: a randomized controlled trial

“…iCEB is an index that can reflect cardiac electrophysiological balance quickly and intuitively, which predicts the risk of arrhythmias, including torsades de pointes (TdP) and non-TdP ventricular tachycardia/ventricular fibrillation [ 28 , 29 ]. The higher the iCEB values, the more likely imbalanced the electrophysiological homeostasis.…”

Comparison of ventricular repolarization parameters including Tp-e, Tp-e/QTc, JTc and JTd during low-flow and high-flow desflurane anesthesia in gynecologic laparoscopic surgery

“…Any prolongation in Tpe interval effects the excitation and conduction, and induces TdP. In the study of Liu et al the effect of desflurane on Tpe interval in three groups with different MAC values at the same FGF rates was investigated and no significantly different prolongation was reported 20 . The authors concluded that desflurane does not have an effect on ventricular transmural dispersion.…”

“…The ratio of Tpe/QT is the ratio of relative to total ventricular refractory period. The higher the ratios the higher proportion of the relative refractory period, so the higher probability of cardiac electrical re-entry 20 . The ratio of Tpe/QT helps us to predict ventricular arrhythmia risk without the effect of HR20 and this why we preferred the Tpe/QTc ratio, as QTc is more reliable than QT.…”