Terao Yoshiaki, Higashijima Ushio, Toyoda Tomomi, Ichinomiya Taiga, Fukusaki Makoto, Hara Tetsuya
Department of Anesthesia, Nagasaki Rosai Hospital, 2-12-5 Setogoe, Sasebo, 857-0134, Japan.
Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
J Anesth. 2016 Dec;30(6):929-934. doi: 10.1007/s00540-016-2252-8. Epub 2016 Sep 21.
Sevoflurane is known to prolong the QT interval. This study aimed to determine the effect of the interaction between intravenous anesthetics and sevoflurane on the QT interval.
The study included 48 patients who underwent lumbar spine surgery. Patients received 3 μg/kg fentanyl and were then randomly allocated to either Group T, in which they received 5 mg/kg thiamylal, or Group P, in which they received 1.5 mg/kg propofol, at 2 min after administration of fentanyl injection for anesthetic induction. Vecuronium (1.5 mg/kg) and sevoflurane (3 % inhaled concentration) were administered immediately after loss of consciousness and tracheal intubation was performed 3 min after vecuronium injection. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and the heart rate-corrected QT (QTc) interval on a 12-lead electrocardiogram were recorded immediately before fentanyl administration (T1), 2 min after fentanyl injection (T2), immediately before intubation (T3), and 2 min after intubation (T4).
There were no significant differences between the two groups in baseline patient characteristics. BIS and MAP significantly decreased after anesthesia induction in both groups. At T3, MAP in Group T was higher than in Group P, while HR had reduced in both groups. The QTc interval was prolonged after anesthesia induction in Group T, but did not change at any time point in Group P. The QTc interval after anesthesia induction in Group T was longer than in Group P.
We concluded that an injection of propofol could counteract QTc interval prolongation associated with sevoflurane anesthesia induction.
已知七氟醚可延长QT间期。本研究旨在确定静脉麻醉药与七氟醚之间的相互作用对QT间期的影响。
本研究纳入48例行腰椎手术的患者。患者接受3μg/kg芬太尼,然后在注射芬太尼进行麻醉诱导2分钟后,随机分为T组(接受5mg/kg硫喷妥钠)或P组(接受1.5mg/kg丙泊酚)。意识消失后立即给予维库溴铵(1.5mg/kg),维库溴铵注射3分钟后进行气管插管。在给予芬太尼前即刻(T1)、芬太尼注射后2分钟(T2)、插管前即刻(T3)和插管后2分钟(T4)记录心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)以及12导联心电图上经心率校正的QT(QTc)间期。
两组患者的基线特征无显著差异。两组麻醉诱导后BIS和MAP均显著降低。在T3时,T组的MAP高于P组,而两组的HR均降低。T组麻醉诱导后QTc间期延长,但P组在任何时间点均未改变。T组麻醉诱导后的QTc间期长于P组。
我们得出结论,注射丙泊酚可抵消与七氟醚麻醉诱导相关的QTc间期延长。