Department of Anaesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Bucheon Hospital, 1174 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, Republic of Korea.
Br J Anaesth. 2010 Feb;104(2):150-7. doi: 10.1093/bja/aep355. Epub 2009 Dec 14.
Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of <1 MAC affect tracheal intubation-induced prolongation of the QT interval.
Forty-four subjects received either inspired desflurane at 1 MAC in oxygen 100% at a fresh gas flow rate of 6 litre min(-1) (desflurane group) or only oxygen 100% (control group) beginning at anaesthesia induction with propofol, before tracheal intubation. The QT intervals were corrected by Bazett's (QTcB) and Fridericia's (QTcF) formulae. The primary outcome was the QTcB immediately after tracheal intubation. Secondary outcomes were the interval from the peak to the end of the T wave (Tp-e), mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) score.
The QTc interval immediately after tracheal intubation did not differ between the control and the desflurane groups [QTcB, 451 (sd 23) vs 456 (27) ms, P=0.56; QTcF, 422 (24) vs 429 (22) ms, P=0.31, control vs desflurane group, respectively]. There was no difference in Tp-e or HR between the two groups in this study. However, MAP and the BIS score were significantly lower in the desflurane group until 1 min after tracheal intubation.
The administration of desflurane at an inspiratory concentration of 1 MAC during manually controlled ventilation after anaesthesia induction with propofol did not affect tracheal intubation-induced QTc prolongation.
超过 1 个最低肺泡有效浓度(MAC)的地氟醚已被证明会延长 QT 间期,但在较低浓度下是否如此尚不清楚。本研究旨在确定 MAC 浓度<1 的地氟醚是否会影响气管插管引起的 QT 间期延长。
44 名患者接受以下处理:吸入地氟醚 1 MAC 复合氧气 100%,新鲜气流率 6 升/分钟(地氟醚组)或仅吸入氧气 100%(对照组),起始于异丙酚诱导麻醉后,行气管插管前。QT 间期通过 Bazett(QTcB)和 Fridericia(QTcF)公式校正。主要结果为气管插管后即刻的 QTcB。次要结果为 T 波峰至终点间期(Tp-e)、平均动脉压(MAP)、心率(HR)和脑电双频指数(BIS)评分。
气管插管后即刻,对照组和地氟醚组的 QT 间期无差异[QTcB,451(23)ms 比 456(27)ms,P=0.56;QTcF,422(24)ms 比 429(22)ms,P=0.31]。两组 Tp-e 或 HR 无差异。然而,地氟醚组的 MAP 和 BIS 评分在气管插管后 1 分钟内显著低于对照组。
在异丙酚诱导麻醉后行手动控制通气时,给予地氟醚吸入浓度为 1 MAC 不会影响气管插管引起的 QT 间期延长。