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机器人辅助腹腔镜前列腺切除术中雷莫司琼对心率校正QT间期的影响:一项随机试验

Heart-Rate-Corrected QT Interval Response to Ramosetron during Robot-Assisted Laparoscopic Prostatectomy: A Randomized Trial.

作者信息

Lee Bora, Kim So Yeon, Kim Seung Hyun, Yang Hyukjin, Jin Jeong Hyun, Choi Seung Ho

机构信息

Department of Anesthesiology and Pain Medicine, Severance Hospital, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

出版信息

J Pers Med. 2022 May 18;12(5):811. doi: 10.3390/jpm12050811.

Abstract

Ramosetron, often used to prevent postoperative nausea and vomiting, might cause heart-rate-corrected (QTc) interval prolongation, as might robot-assisted laparoscopic prostatectomy (RALP), which requires a steep Trendelenburg position and CO2 pneumoperitoneum. This study aimed to determine how ramosetron administration affects the QTc interval in patients treated with RALP. Fifty-six subjects were randomly assigned to ramosetron (n = 28) or control (n = 28) groups. The ramosetron group received 0.3 mg of ramosetron after anesthetic induction, whereas the control group received normal saline. The QTc interval was measured before and after induction; after 5, 30, and 60 min of being placed in the Trendelenburg position; immediately after being returned to a supine position; and at the end of surgery. Linear mixed models were used to compare QT intervals between groups. QTc intervals did not differ significantly between groups over time (Pgroup×time = 0.111). However, they increased significantly in both groups after placement in the Trendelenburg position compared with before induction (Ptime < 0.001). This increase in QTc continued until the end of surgery in both groups. Based on these findings, ramosetron can be safely administered for the prevention of postoperative nausea and vomiting among patients undergoing RALP.

摘要

雷莫司琼常用于预防术后恶心和呕吐,可能会导致心率校正(QTc)间期延长,机器人辅助腹腔镜前列腺切除术(RALP)也可能如此,该手术需要采用陡峭的头低脚高位和二氧化碳气腹。本研究旨在确定雷莫司琼给药对接受RALP治疗患者的QTc间期有何影响。56名受试者被随机分为雷莫司琼组(n = 28)和对照组(n = 28)。雷莫司琼组在麻醉诱导后接受0.3mg雷莫司琼,而对照组接受生理盐水。在诱导前后、置于头低脚高位5分钟、30分钟和60分钟后、恢复仰卧位后以及手术结束时测量QTc间期。使用线性混合模型比较两组之间的QT间期。两组间QTc间期随时间无显著差异(P组×时间 = 0.111)。然而,与诱导前相比,两组在置于头低脚高位后QTc间期均显著增加(P时间 < 0.001)。两组的QTc间期增加一直持续到手术结束。基于这些发现,雷莫司琼可安全用于预防接受RALP治疗患者的术后恶心和呕吐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7621/9146018/8f2b254cc2d9/jpm-12-00811-g001.jpg

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