The effects of intravenous anesthetics on QT interval during anesthetic induction with desflurane

Abstract

Introduction: This study aimed to determine the effects of the interaction between intravenous anesthetics and desflurane on the QT interval. Methods: Fifty patients who underwent lumbar spine surgery were included. The patients received 3 μg/kg fentanyl and were randomly divided into two groups: group P patients received 1.5 mg/kg propofol and group T patients received 5 mg/kg thiamylal 2 min after fentanyl injection. All patients received rocuronium and desflurane (6% inhaled concentration) after loss of consciousness. Tracheal intubation was performed 3 min after rocuronium injection. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and the heart rate-corrected QT (QTc) interval on a 12-lead electrocardiograms were recorded before fentanyl injection (T1), 2 min after fentanyl injection (T2), 1 min after propofol or thiamylal injection (T3), immediately before intubation (T4), and 2 min after intubation (T5). Results: There were no significant intergroup differences in patient characteristics. BIS and MAP decreased after anesthesia induction in both groups. MAP values at T3, T4, and T5 in group T were higher than those in group P. HR did not change over time or differ between the groups. The QTc intervals at T4 and T5 in group T were longer than those at T1. In group P, the QTc interval at T3 was significantly shorter than that at T1. The QTc intervals at T3, T4, and T5 in group T were significantly longer than those in group P. Conclusions: A propofol injection could counteract the QTc interval prolongation during desflurane anesthesia induction. Trial registration: UMIN Clinical Trials Registry database reference number: UMIN000023707. This study was registered on August 21, 2016.

Effects of Anesthetics on Cardiac Repolarization in Adults: A Network Meta-Analysis of Randomized Clinical Trials

“…QTD, the difference between the maximum and minimum QT intervals, is considered an index of left ventricular repolarization inhomogeneity [26]. Increased QTD or QTcD is a sign of heterogeneous repolarization and possible arrhythmogenic re-entry [27].…”

“…Although inhalational anesthetics significantly increased the QTc interval, no dysrhythmia was reported during anesthesia with inhalational anesthetics in the studies included this meta-analysis. Some RCTs [17,26,[30][31][32][33] reported that transient dysrhythmias, such as supraventricular arrhythmia, ventricular arrhythmias, and idioventricular rhythm, were detected in the treatment of anesthetics including propofol, thiamylal, thiopentone, sevoflurane, isoflurane, and halothane, but no intergroup differences were reported. This might have occurred because all the RCTs investigated adult patients with normal QTc interval and no cardiovascular diseases.…”