Tanskanen P E, Kyttä J V, Randell T T
Töölö Hospital, Helsinki University Central Hospital, Department of Anaesthesia, Helsinki, Finland.
Eur J Anaesthesiol. 2002 Oct;19(10):749-54. doi: 10.1017/s0265021502001217.
Thiopental prolongs the QT interval more than propofol, and the two induction agents were compared in patients with subarachnoid haemorrhage predisposed to electrocardiographic abnormalities and cardiac dysrhythmias.
Twenty-nine patients were studied randomly. Anaesthesia was induced with either thiopental or propofol and fentanyl; vecuronium was used as a neuromuscular blocking agent. The electrocardiogram and arterial blood pressure were monitored from before the induction of anaesthesia to 2 min after endotracheal intubation.
The median QT interval was at baseline 423 ms in the thiopental group and at 432 ms in the propofol group, and it increased in the thiopental group to 446 ms and decreased in the propofol group to 425 ms (P < 0.01 between groups). After induction and endotracheal intubation, the number of patients with increased QT dispersion was greater in the propofol group (P < 0.05). The incidence of cardiac dysrhythmias was similar in the study groups.
Thiopental and propofol are equally suitable for the induction of anaesthesia in patients with subarachnoid haemorrhage.
硫喷妥钠比丙泊酚更易延长QT间期,本研究在易出现心电图异常和心律失常的蛛网膜下腔出血患者中比较了这两种诱导麻醉药物。
随机研究29例患者。采用硫喷妥钠或丙泊酚与芬太尼诱导麻醉;维库溴铵用作神经肌肉阻滞剂。从麻醉诱导前至气管插管后2分钟监测心电图和动脉血压。
硫喷妥钠组QT间期基线中位数为423毫秒,丙泊酚组为432毫秒,硫喷妥钠组增加至446毫秒,丙泊酚组降至425毫秒(组间P<0.01)。诱导和气管插管后,丙泊酚组QT离散度增加的患者数量更多(P<0.05)。研究组中心律失常的发生率相似。
硫喷妥钠和丙泊酚同样适用于蛛网膜下腔出血患者的麻醉诱导。