Aypar Ebru, Karagoz Ayse Heves, Ozer Sema, Celiker Alpay, Ocal Turgay
Section of Pediatric Cardiology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Paediatr Anaesth. 2007 Jun;17(6):563-7. doi: 10.1111/j.1460-9592.2006.02152.x.
Inhalational anesthetics may prolong QTc interval (QT interval corrected for heart rate) of the ECG and cause life-threatening arrythmias. The effects of desflurane on QTc interval and cardiac rhythm have not been reported previously in children. We assessed the effects of desflurane anesthesia on QTc interval and cardiac rhythm and compared them with sevoflurane anesthesia in children.
The study was performed on 20 children admitted for inguinal hernia repair, with normal QTc intervals. Anesthesia was induced with propofol and intubation was achieved with vecuronium. Anesthesia was maintained with 2% sevoflurane (group I, n = 11) or 6% desflurane (group II, n = 9) and 66% nitrous oxide in oxygen. Electrocardiogram recordings were obtained by Holter recorder. QTc intervals were measured at baseline, 5, 10, 15, and 30 min after inhalation.
None of the patients had significant arrythmia with desflurane anesthesia. One patient in the sevoflurane group had single, bigemini and multiform ventricular extrasystoles. There was no statistically significant difference in the baseline QTc values of the groups. Desflurane significantly prolonged QTc interval 5 min after induction until 30 min of anesthesia compared with baseline values (P = 0.029), while no significant prolongation was observed with sevoflurane (P = 0.141).
Use of 2% sevoflurane during maintenance of anesthesia does not significantly prolong QTc interval while 6% desflurane significantly prolonged QTc interval in children with normal QTc interval undergoing inguinal herniorrhaphy.
吸入性麻醉剂可能会延长心电图的QTc间期（校正心率后的QT间期），并导致危及生命的心律失常。地氟醚对儿童QTc间期和心律的影响此前尚未见报道。我们评估了地氟醚麻醉对儿童QTc间期和心律的影响，并将其与七氟醚麻醉进行比较。
对20名因腹股沟疝修补术入院且QTc间期正常的儿童进行了研究。采用丙泊酚诱导麻醉，维库溴铵实现插管。用2%七氟醚（I组，n = 11）或6%地氟醚（II组，n = 9）和66%氧化亚氮/氧气维持麻醉。通过动态心电图记录仪进行心电图记录。在吸入后基线、5、10、15和30分钟测量QTc间期。
接受地氟醚麻醉的患者均未出现明显心律失常。七氟醚组有1例患者出现单发、成对和多形性室性早搏。两组的基线QTc值无统计学显著差异。与基线值相比，地氟醚在诱导后5分钟至麻醉30分钟期间显著延长了QTc间期（P = 0.029），而七氟醚未观察到显著延长（P = 0.141）。
在接受腹股沟疝修补术且QTc间期正常的儿童中，麻醉维持期间使用2%七氟醚不会显著延长QTc间期，而6%地氟醚会显著延长QTc间期。
