Saarnivaara L, Hiller A, Oikkonen M
Department of Anaesthesia, Otolaryngological Hospital, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1993 May;37(4):419-23. doi: 10.1111/j.1399-6576.1993.tb03740.x.
The effects on corrected QT interval (QTc), heart rate and arterial pressure were studied after induction with propofol 1.5, 2 or 2.5 mg.kg-1, thiopentone 5 mg.kg-1 or methohexitone 2 mg.kg-1 in 123 ASA class I or II children undergoing outpatient otolaryngological surgery. Premedication consisted of oral midazolam and atropine. The children were randomly allocated to one of the three propofol groups or to the thiopentone or methohexitone group. After injection of the intravenous anaesthetic, the QTc interval was significantly prolonged after propofol 2.5 mg.kg-1. Thirty seconds after suxamethonium 1.5 mg.kg-1, a significant prolongation of the QTc interval occurred in the thiopentone and propofol 1.5 and 2 mg.kg-1 groups. After intubation, no further prolongation of the QTc interval occurred in any of the groups. Heart rate increased significantly after the barbiturates but not after propofol. Systolic arterial pressure decreased significantly after propofol 1.5 and 2.5 mg.kg-1. In all groups a cardiovascular intubation response occurred. Bradycardia and junctional rhythm occurred in 4% of the children in both barbiturate groups and in 19-29% in the propofol groups. It is concluded that propofol causes prolongation of the QT interval and results in a higher incidence of bradycardia and junctional rhythm than the barbiturates.
在123例接受门诊耳鼻喉科手术的美国麻醉医师协会（ASA）Ⅰ或Ⅱ级儿童中，研究了分别给予1.5、2或2.5mg·kg-1丙泊酚、5mg·kg-1硫喷妥钠或2mg·kg-1美索比妥诱导后对校正QT间期（QTc）、心率和动脉压的影响。术前用药包括口服咪达唑仑和阿托品。将儿童随机分配至丙泊酚三个组之一或硫喷妥钠组或美索比妥组。静脉注射麻醉药后，2.5mg·kg-1丙泊酚组的QTc间期显著延长。1.5mg·kg-1琥珀胆碱注射30秒后，硫喷妥钠组以及1.5和2mg·kg-1丙泊酚组的QTc间期显著延长。插管后，所有组的QTc间期均未进一步延长。巴比妥类药物注射后心率显著增加，但丙泊酚注射后未出现这种情况。1.5和2.5mg·kg-1丙泊酚注射后收缩压显著降低。所有组均出现心血管插管反应。两个巴比妥类药物组中4%的儿童出现心动过缓和交界性心律，丙泊酚组中这一比例为19% - 29%。结论是，与巴比妥类药物相比，丙泊酚可导致QT间期延长，并导致心动过缓和交界性心律的发生率更高。
