Department of Anesthesiology and Reanimation, Harran University Medical Faculty, Sanliurfa, Turkey.
Department of Obstetrics and Gynecology, Harran University Medical Faculty, Sanliurfa, Turkey.
Int J Clin Pract. 2021 Jun;75(6):e14154. doi: 10.1111/ijcp.14154. Epub 2021 Mar 26.
Pregnancy affects the cardiovascular system, particularly the cardiac conduction system, thereby increasing the susceptibility of patients towards arrhythmia. QT interval results in ventricular arrhythmias, predominantly polymorphic ventricular tachycardia. The present study was planned to investigate the relationship between a gestational week and QT dispersion in cesarean section patients undergoing spinal anaesthesia.
The study included 40 patients between the ages of 18 and 45 who had no symptoms of anaemia and undergoing elective cesarean section. The patients were separated into two groups based on the gestational week as Group I <39 weeks and Group II ≥39 weeks. The patient was given a sitting position and the puncture site was cleansed with 10% povidone-iodine antiseptic solution. After placing a sterile drape on the patient, the subarachnoid space was punctured through an appropriate vertebral space (L3-L4 or L4-L5) using a pencil-point 25G spinal needle, followed by intrathecal injection of 12.5 mg (2.5 mL) 5% hyperbaric bupivacaine hydrochloride. Electrocardiographic (ECG) records were obtained both preoperatively and at 1, 5, and 10 minutes after spinal block, and the QT, QTc, QTd, and corrected QTd (QTcd) intervals were estimated using Bazett's formula.
There was no significant difference between the two groups within the QT and QTc intervals. QTcd measured after post-operative was significantly higher in Group II (P = .007).
The results indicated that spinal anaesthesia may prolong the QTdc interval in patients with a gestational week of ≥39 weeks undergoing cesarean section.
妊娠会影响心血管系统,尤其是心脏传导系统,从而增加患者心律失常的易感性。QT 间期导致室性心律失常,主要是多形性室性心动过速。本研究旨在探讨脊髓麻醉下剖宫产患者妊娠周数与 QT 离散度的关系。
本研究纳入了年龄在 18 至 45 岁之间、无贫血症状且择期行剖宫产的 40 名患者。根据妊娠周数将患者分为两组:I 组<39 周,II 组≥39 周。患者取坐位,穿刺部位用 10%聚维酮碘消毒剂消毒。患者铺无菌巾后,用笔尖 25G 脊髓针通过合适的椎间隙(L3-L4 或 L4-L5)穿刺蛛网膜下腔,随后行鞘内注射 12.5mg(2.5mL)5%重比重布比卡因盐酸盐。分别于术前、脊髓阻滞后 1、5 和 10 分钟记录心电图(ECG),并采用 Bazett 公式计算 QT、QTc、QTd 和校正的 QTd(QTcd)间期。
两组间 QT 和 QTc 间期无显著差异。术后 QTcd 在 II 组明显升高(P=0.007)。
结果表明,脊髓麻醉可能会延长≥39 周妊娠周数行剖宫产患者的 QTdc 间期。