单次瑞芬太尼推注对七氟醚诱导期间校正 QT 间期变化的影响。

The effects of a single bolus of remifentanil on corrected QT interval change during sevoflurane induction.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.

出版信息

Yonsei Med J. 2011 Mar;52(2):333-8. doi: 10.3349/ymj.2011.52.2.333.

DOI:10.3349/ymj.2011.52.2.333

PMID:21319355

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3051204/

Abstract

PURPOSE

Opioids may affect changes in the corrected QT interval (QTc) during anesthetic induction. This study examine whether a single bolus of remifentanil would prolong QTc after laryngeal mask airway (LMA) insertion during sevoflurane induction.

MATERIALS AND METHODS

Forty women of American Society of Anesthesiologists physical status 1 (ASA PS1) undergoing gynecological surgery were studied. All patients were induced using three vital capacity inhalation inductions with 5% sevoflurane. Two minutes after induction, the inspiratory concentration of sevoflurane was reduced to 2%. Using double-blinded randomization, patients were allocated into one of two groups, receiving either saline (placebo group, n = 20) or 0.25 μg.kg⁻¹ remifentanil (remifentanil group, n = 20) over a period of thirty seconds. Sixty seconds later, LMA insertion was performed. Recordings were taken with a 12-lead electrocardiogram at baseline, 2 min after induction and 1 and 3 min after LMA insertion. QTc was calculated by Bazett's formula. The mean arterial pressure (MAP) and heart rate (HR) were also measured at each time point.

RESULTS

The QTc interval was significantly prolonged in the placebo group as compared to the remifentanil group at 1 min after LMA insertion (467.8 ± 16.5 vs. 442.7 ± 21.3 ms, p < 0.001). However, there was no significant difference in QTc at 3 min after LMA insertion between the two groups. MAP and HR were significantly higher in the placebo group (p < 0.001).

CONCLUSION

A single bolus of remifentanil is safe method to attenuate prolonged QTc associated with insertion of LMA.

摘要

目的

阿片类药物可能会影响麻醉诱导期间校正的 QT 间期（QTc）的变化。本研究旨在探讨单次推注瑞芬太尼是否会在七氟醚诱导下插入喉罩（LMA）时延长 QTc。

材料和方法

研究了 40 名美国麻醉医师协会身体状况 1 级（ASA PS1）的女性患者，她们正在接受妇科手术。所有患者均采用 3 次肺活量吸入诱导，吸入 5%七氟醚。诱导后 2 分钟，将七氟醚的吸气浓度降低至 2%。采用双盲随机分组，患者被分为两组，分别接受生理盐水（安慰剂组，n=20）或 0.25μg·kg-1瑞芬太尼（瑞芬太尼组，n=20），持续 30 秒。60 秒后进行 LMA 插入。在基线、诱导后 2 分钟和 LMA 插入后 1 分钟和 3 分钟时，使用 12 导联心电图进行记录。通过 Bazett 公式计算 QTc。在每个时间点还测量平均动脉压（MAP）和心率（HR）。