QTc Interval During Desflurane Anesthesia: The Effects of Intravenous Lidocaine Prior to Intubation

Abstract

A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Prolongation of the corrected QT (QTc) interval is an important predictor for the risk of polymorphic ventricular tachycardia and ventricular fibrillation. Volatile inhalational anaesthetics and intubation may cause prologation in the QTc interval. Lidocaine can be useful in preventing intubation-related cardiovascular responses. The aim of this study was to investigate whether administration of intravenous (iv) lidocaine prior to intubation would prevent the prolongation of QTc interval occuring after tracheal intubation (TI) during desflurane anesthesia. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The study group included 82 patients, all admitted for elective surgery. Anesthesia induction was provided with midazolam (0.3 mg/kg). After loss of eyelash reflex, the anaesthetic circuit was filled with desflurane and oxygen, then manually controlled ventilation was started. Cisatracurium besylate (0.15 mg/kg) was administered for muscle relaxation. After administration of muscle relaxant, either 1.5 mg/kg iv lidocaine or placebo were administered to the patients in study group (n=41) and control group (n=41), respectively. Two minutes after the administration of drugs, TI was performed at first attempt. The electrocardiography (ECG) recordings were obtained at four occasions; before anesthesia induction, after reaching steady state concentration of end tidal desflurane, just after intubation and 10 minutes after intubation. The QTc intervals, QT dispersion (QTd) and QTcd (QTc max -QTc min ) were calculated. R Re es su ul lt ts s: : QTc interval was prolonged after anesthesia induction. After intubation, QTc interval was significantly prolonged and remained so for 10 more minutes. C Co on nc cl lu us si io on n: : In this study, lidocaine could not prevent prolongation of the QTc interval occuring after TI during desflurane anesthesia. K Ke ey y W Wo or rd ds s: : Lidocaine; desflurane; electrocardiography, ambulatory; intubation, intratracheal Ö ÖZ ZE ET T A Am ma aç ç: : Dü zel til miş QT (QTc) ara lı ğı nın uza ma sı, po li mor fik ven tri kül ta şi kar di si ve ven trikül fib ri las yo nu için önem li bir ön cül bul gu dur. Uçu cu in ha las yo nel anes te tik ler ve in tü bas yon, QTc ara lı ğı nın uza ma sı na ne den ola bil mek te dir. Li do ka i nin, in tü bas yo na bağ lı ola rak ge li şen kar di yovas kü ler ya nıt la rın ön len me sin de ya rar lı ol du ğu gös te ril miş tir. Bu ça lış ma nın ama cı, in tü bas yon ön-ce si in tra ve nöz (iv) li do ka in uy gu la ma sı nın, desf lu ran anes te zi si al tın da ki has ta lar da tra ke al in tü bas yon (TI) uy gu la ma la rı son ra sı ge li şen QTc ara lı ğın da ki uza ma yı ön le yip ön le ye me ye ce ği ni araş tır mak tır. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Ça lış ma gru bu elek tif cer ra hi için ya tı rı lan 82 has ta dan oluş -mak ta dır. Anes te zi in dük si yo nu mi da zo lam (0.3 mg/kg) ile sağ lan dı. Has ta lar da kir pik ref lek si nin kay bol ma sın dan...