Owczuk R, Wujtewicz M A, Sawicka W, Wujtewicz M, Swierblewski M
Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Debinki str. 7, 80-211 Gdansk, Poland.
Br J Anaesth. 2004 May;92(5):658-61. doi: 10.1093/bja/aeh132. Epub 2004 Apr 2.
Inhalation anaesthetics and anthracycline chemotherapeutic drugs may both prolong the QT interval of the electrocardiogram. We investigated whether isoflurane may induce or augment QTc prolongation in patients who had previously received cancer chemotherapy including anthracycline drugs.
Forty women undergoing surgery for breast cancer were included in the study. They were divided into two groups: (A) women previously treated with anthracyclines (n=20); and (B) women not treated with antineoplastic drugs (n=20). All patients received a standardized balanced anaesthetic in which isoflurane 0.5 vol% was used. The QT and corrected QT intervals were measured before anaesthesia, after induction and tracheal intubation, after 1, 5, 15, 30, 60 and 90 min of anaesthesia, and during recovery.
In both groups we observed a tendency to QTc prolongation, but statistically significant differences among baseline values and values observed during isoflurane-containing anaesthesia were seen only in group A. During anaesthesia, significant differences in QTc values between the two groups were observed.
In female patients pretreated with anthracyclines for breast cancer, the tendency to QTc prolongation during isoflurane-containing general anaesthesia was more strongly expressed than in patients without previous chemotherapy.
吸入麻醉药和蒽环类化疗药物均可延长心电图的QT间期。我们研究了异氟烷是否会在先前接受过包括蒽环类药物在内的癌症化疗的患者中诱发或加剧QTc延长。
40名接受乳腺癌手术的女性纳入本研究。她们被分为两组：（A）先前接受过蒽环类药物治疗的女性（n = 20）；（B）未接受过抗肿瘤药物治疗的女性（n = 20）。所有患者均接受标准化的平衡麻醉，其中使用0.5%体积分数的异氟烷。在麻醉前、诱导和气管插管后、麻醉1、5、15、30、60和90分钟后以及恢复期间测量QT和校正QT间期。
两组均观察到QTc延长的趋势，但仅在A组中观察到基线值与含异氟烷麻醉期间观察值之间的统计学显著差异。麻醉期间，两组间QTc值存在显著差异。
在先前接受蒽环类药物治疗的乳腺癌女性患者中，含异氟烷全身麻醉期间QTc延长的趋势比未接受过化疗的患者更明显。
