Nurse Anesthesia Track, School of Nursing, The University of Alabama at Birmingham, Birmingham, AL.
London Health Science Center, London, Ontario, Canada.
J Perianesth Nurs. 2020 Apr;35(2):104-111. doi: 10.1016/j.jopan.2019.09.003. Epub 2020 Jan 16.
Prolongation of the QT interval can predispose patients to fatal arrhythmias such as torsade de pointes. While arrhythmias can occur spontaneously in patients with a genetic predisposition, drugs such as ondansetron and droperidol, which are frequently used in the perioperative period, have been implicated in the prolongation of the QT interval. As the list of medications that cause QT prolongation grows, anesthesia providers and perioperative nurses must be informed regarding the importance of the QT interval. This article reviews the physiology and measurement of the QT interval, the risk factors of QT prolongation, the mechanism of drug-induced QT prolongation, and perioperative considerations for patient care.
QT 间期延长可使患者易患尖端扭转型室性心动过速等致命性心律失常。虽然具有遗传易感性的患者可能会自发发生心律失常,但在围手术期经常使用的药物(如昂丹司琼和氟哌利多)已被认为可导致 QT 间期延长。随着导致 QT 间期延长的药物清单的增加,麻醉提供者和围手术期护士必须了解 QT 间期的重要性。本文回顾了 QT 间期的生理学和测量、QT 延长的危险因素、药物引起的 QT 延长的机制以及患者护理的围手术期注意事项。