Differential effects of propofol and sevoflurane on QT interval during anesthetic induction

Oji, Makito; Terao, Yoshiaki; Toyoda, Tomomi; Kuriyama, Tomoyuki; Miura, Keiji; Fukusaki, Makoto; Sumikawa, Koji

doi:10.1007/s10877-012-9420-7

Cited by 41 publications

(31 citation statements)

References 23 publications

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“…There have been conflicting reports regarding whether propofol sedation lengthens, shortens, or does not affect QT intervals. Kim et al (21) reported lengthening of the QTc intervals by propofol administration, whereas Oji et al (22) reported shortening of the QTc interval. Whyte et al (13) found no effect of propofol on QTc interval.…”

Section: Discussionmentioning

confidence: 99%

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

Bolat

Celıkbılek²,

Sarıkaya³

et al. 2015

Anatol J Cardiol

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Objective:Combined sedation with propofol and benzodiazepines, known as balanced propofol sedation (BPS), was developed to increase patient comfort during endoscopy. However, the effects of BPS on P-wave dispersion (Pwd), QT interval, and corrected QT (QTc) interval after endoscopy have not been investigated.Methods:The study population consisted of 40 patients with BPS and 42 without sedation who were scheduled to undergo upper endoscopy in this cross-sectional prospective study. Patients with hypertension, diabetes mellitus, renal failure, chronic obstructive pulmonary disease, coronary artery disease, or valvular heart disease and those on medications that interfere with cardiac conduction times were excluded. Electrocardiograms (ECGs) was recorded in all patients pre-endoscopy and 10 min post-endoscopy. QT, QT dispersion (QTd), and Pwd were defined from 12-lead ECG. The QTc interval was calculated using Bazett’s formula. All analyses were performed using SPSS 15.0.Results:Post-endoscopy P max duration and Pwd were prolonged compared with baseline values (86±13 ms vs. 92±10 ms and 29±12 ms vs. 33±12 ms, respectively; p<0.05). Post-endoscopy QTc and QTd were decreased compared with baseline values, but these decreases were not statistically significant (431±25 ms vs. 416±30 ms and 62±28 ms vs. 43±22 ms, respectively; p>0.05).Conclusion:The present study showed that P-wave duration and Pwd values increased after endoscopy with a combination of midazolam and propofol sedation. Physicians should be made aware of the potential effects of BPS in terms on P-wave duration and Pwd values.

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Section: Discussionmentioning

confidence: 99%

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

Bolat

Celıkbılek²,

Sarıkaya³

et al. 2015

Anatol J Cardiol

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“…However, there have been conflicting reports on the QTcD-prolonging effects of desflurane [1,5]. Our previous studies showed that propofol or thiamylal with sevoflurane does not affect QTD in similar study populations [2,14]. Altogether, these studies suggest that co-existing cardiac disease could influence QTcD during desflurane anesthesia induction.…”

Section: Discussionmentioning

confidence: 94%

“…We chose to use average values from the 12-lead ECG because of inter-lead variations in the QT interval [13]. Moreover, we previously found that propofol shortens the QTc interval [6,14], and an injection of propofol counteracted the QTc interval prolongations associated with sevoflurane anesthesia induction [2] and antiemetic dose of droperidol [15]. Sympathetic stimulation is one of the factors interfering with the QTc interval.…”

Section: Discussionmentioning

confidence: 99%

The effects of intravenous anesthetics on QT interval during anesthetic induction with desflurane

et al. 2018

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Introduction: This study aimed to determine the effects of the interaction between intravenous anesthetics and desflurane on the QT interval. Methods: Fifty patients who underwent lumbar spine surgery were included. The patients received 3 μg/kg fentanyl and were randomly divided into two groups: group P patients received 1.5 mg/kg propofol and group T patients received 5 mg/kg thiamylal 2 min after fentanyl injection. All patients received rocuronium and desflurane (6% inhaled concentration) after loss of consciousness. Tracheal intubation was performed 3 min after rocuronium injection. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and the heart rate-corrected QT (QTc) interval on a 12-lead electrocardiograms were recorded before fentanyl injection (T1), 2 min after fentanyl injection (T2), 1 min after propofol or thiamylal injection (T3), immediately before intubation (T4), and 2 min after intubation (T5). Results: There were no significant intergroup differences in patient characteristics. BIS and MAP decreased after anesthesia induction in both groups. MAP values at T3, T4, and T5 in group T were higher than those in group P. HR did not change over time or differ between the groups. The QTc intervals at T4 and T5 in group T were longer than those at T1. In group P, the QTc interval at T3 was significantly shorter than that at T1. The QTc intervals at T3, T4, and T5 in group T were significantly longer than those in group P. Conclusions: A propofol injection could counteract the QTc interval prolongation during desflurane anesthesia induction. Trial registration: UMIN Clinical Trials Registry database reference number: UMIN000023707. This study was registered on August 21, 2016.

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“…Anesthesia was induced with target-controlled infusion (TCI) of propofol and remifentanil. The target predicted plasma concentration of propofol was 3.0 μg/mL [18]. This predicted plasma propofol concentration was kept stable for 3 minutes and then remifentanil TCI begun.…”

Section: Anesthesia Protocolmentioning

confidence: 94%

Effect of intravenous lidocaine combined with dexmedetomidine on postoperative nausea and vomiting after laparoscopic total hysterectomy

Xu¹,

Ju²,

Wang³

et al. 2019

Preprint

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Background A few studies have manifested that intravenous (IV) lidocaine or dexmedetomidine decreased the incidence of postoperative nausea and vomiting (PONV). We investigated whether lidocaine plus dexmedetomidine infusion could better reduce the incidence of PONV than placebo after laparoscopic total hysterectomy. Methods This prospective, randomized controlled study enrolled 126 women undergoing elective laparoscopic total hysterectomy with general anesthesia. They divided into the following two groups: patients in the lidocaine combined with dexmedetomidine group (group LD) received lidocaine (1.5 mg/kg loading, 1.5 mg/kg/h infusion) and dexmedetomidine (0.5 μg/kg loading, 0.4 μg/kg/h infusion), respectively. Patients in the control group (group CON) received the equal volume of saline. The primary outcome was the incidence of nausea, vomiting and PONV for the first 48 hours after surgery. The secondary outcomes included intraoperative propofol and remifentanil consumption, postoperative fentanyl requirement, Ramsay sedation score, and the incidence of bradycardia during post-anesthesia care unit (PACU) stay period. Results Data of 59 in CON and 60 in LD groups were analyzed. The incidence of nausea, vomiting, and PONV in group LD during the 0 to 2 hours and 24 to 48 hours after the operation was slightly lower than group CON, but the difference was not statistically significant between the two groups. The incidence of nausea, vomiting, and PONV was much lower in group LD than group CON at 2 to 24 hours after surgery (P<0.05, P<0.01, P<0.01, respectively). The cumulative requirement of fentanyl during the first 48 hours after surgery was significantly reduced in group LD compared to group CON (P<0.01, P<0.01, P<0.05, respectively). Propofol and remifentanil total dose in the intraoperative period was significantly lower in group LD compared with group CON (P<0.01 and P<0.01). However, the level of sedation and incidence of bradycardia during the PACU stay period were markedly increased in group LD compared with group CON (P<0.01 and P<0.01). Conclusion Lidocaine plus dexmedetomidine infusion markedly decreased the occurrence of nausea, vomiting and PONV within the 2 to 24 hours after laparoscopic total hysterectomy with general anesthesia. However, it increased the incidence of bradycardia and the level of sedation during the PACU stay period.

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Differential effects of propofol and sevoflurane on QT interval during anesthetic induction

Cited by 41 publications

References 23 publications

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

The effects of intravenous anesthetics on QT interval during anesthetic induction with desflurane

Effect of intravenous lidocaine combined with dexmedetomidine on postoperative nausea and vomiting after laparoscopic total hysterectomy

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