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七氟醚延长了一名长QT综合征3型患者的QTc间期并增加了跨壁复极离散度：一例病例报告。

Sevoflurane prolonged the QTc interval and increased transmural dispersion of repolarization in a patient with long QT syndrome 3: a case report.

作者信息

Kitaura Atsuhiro, Nakao Shinichi, Hamasaki Shinichi, Houri Kei, Tsujimoto Takatoshi, Kimura Seishi, Matsushima Mayuka

机构信息

Department of Anesthesiology, Kindai University Faculty of Medicine, 377-2 Ono-Higashi, Osaka-Sayama, 589-8511 Osaka Japan.

出版信息

JA Clin Rep. 2017;3(1):29. doi: 10.1186/s40981-017-0093-6. Epub 2017 May 18.

DOI:10.1186/s40981-017-0093-6
PMID:29457073
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5804612/
Abstract

We report that sevoflurane not only caused marked QTc interval prolongation but also increased transmural dispersion of repolarization in a patient with long QT syndrome 3 (LQT3). A 16-year-old male with LQT3 underwent a shoulder operation. He experienced no episode of syncope or cardiac arrest, but his preoperative electrocardiography (ECG) showed marked QTc interval prolongation (631 ms) and Tp-e interval prolongation (126 ms). Anesthesia was induced with propofol and maintained with 2% sevoflurane and remifentanil. Although no lethal arrhythmias occurred in the perioperative period, not only the QTc interval but also Tp-e interval was further prolonged by sevoflurane. While sevoflurane has been recognized as a safe anesthetic in terms of QT interval prolongation, even in patients with long QT syndromes, we believe that sevoflurane might be avoided for poorly controlled LQT3 patients.

摘要

我们报告，七氟醚不仅导致长QT综合征3（LQT3）患者QTc间期显著延长，还增加了复极跨壁离散度。一名16岁的LQT3男性患者接受了肩部手术。他未发生晕厥或心脏骤停，但术前心电图（ECG）显示QTc间期显著延长（631毫秒）和Tp-e间期延长（126毫秒）。采用丙泊酚诱导麻醉，并用2%七氟醚和瑞芬太尼维持麻醉。尽管围手术期未发生致死性心律失常，但七氟醚不仅使QTc间期进一步延长，还使Tp-e间期延长。虽然七氟醚在QT间期延长方面被认为是一种安全的麻醉剂，即使在长QT综合征患者中也是如此，但我们认为对于LQT3控制不佳的患者应避免使用七氟醚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a7/6967334/81759a2454e0/40981_2017_93_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a7/6967334/ef2709718c6e/40981_2017_93_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a7/6967334/81759a2454e0/40981_2017_93_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a7/6967334/ef2709718c6e/40981_2017_93_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29a7/6967334/81759a2454e0/40981_2017_93_Fig2_HTML.jpg

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