Efeito de esmolol sobre o intervalo QT corrigido e alterações da dispersão do intervalo QT corrigido observadas durante a indução da anestesia em pacientes hipertensos que receberam um inibidor da enzima conversora de angiotensina

Çeker, Zahit; Takmaz, Suna Akın; Baltaci, Bülent; Başar, Hülya

doi:10.1016/j.bjan.2014.03.008

Cited by 2 publications

(4 citation statements)

References 32 publications

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“…Nonetheless, compared with the baseline values, QTc was prolonged post LTI in the control group. A similar pattern post LTI was noted for QTcd as well in patients treated with esmolol compared with controls 9. The mean QTcd was 19 ms in the esmolol group and 24 ms in the control group, and the maximun QTcd noted in the control group after intubation was 35 ms.…”

Section: Resultssupporting

confidence: 74%

“…Four studies had patients with an ASA status I-II undergoing various elective surgeries,17–20 two had patients with documented coronary artery disease7 and hypertension9 respectively and one study was conducted in patients undergoing CABG 10…”

Section: Resultsmentioning

confidence: 99%

“…The QTc analysis was carried out at multiple time frames post intubation from 30 s until 10 min. All the studies assessed corrected QTc, and one study assessed QTcd as well 9. Bazzett’s formula was used for rate correction in five studies, whereas the remaining studies used Hodges’10 and Fredericia’s7 formulas, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Adverse events were reported in two trials, one involving hypertensive patients and the other analysing patients undergoing CABG 9 10. Of the combined 120 patients in these studies (60 esmolol and 60 control), eleven patients in the control group developed less severe ventricular arrhythmias as compared with two in the esmolol group.…”

Section: Resultsmentioning

confidence: 99%

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Effects of esmolol on QTc interval changes during tracheal intubation: a systematic review

et al. 2019

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Introduction and aimsEsmolol is an ultra-short-acting β1 antagonist that has been shown to attenuate the corrected QT (QTc) interval prolongation associated with laryngoscopy and endotracheal intubation (LTI). Prolongation of the QTc interval can precipitate arrhythmias, the most serious of which is torsades de pointes . The aim of this systematic review was to compare esmolol and placebo on QTc changes occurring during LTI.Materials and methodsPubMed, EMBASE, Cochrane Registry of Clinical Trials and CINAHL databases (up to August 2018) were screened for randomised controlled trials comparing esmolol and placebo on QTc changes during LTI in cardiac and non-cardiac surgeries. The primary outcome was QTc changes during LTI and secondary outcome was related to adverse effects from esmolol such as bradycardia and hypotension.ResultsSeven trials were identified involving 320 patients, 160 patients receiving esmolol or placebo apiece. A shortening of the QTc post-LTI was evident in the esmolol group compared with the placebo in four studies. Compared with the baseline, the QTc was reduced post-LTI in the esmolol group. In the placebo group, the QTc was prolonged compared with the baseline post LTI. Nonetheless, esmolol did not prevent QTc prolongation in the remaining three studies, and much of this was attributed to employing QTc prolonging agents for premedication and anaesthetic induction. No significant adverse events were noted.ConclusionCompared with placebo, esmolol reduced the LTI-induced QTc prolongation when current non-QTc prolonging agents were chosen for tracheal intubation. Future studies should explore whether transmural dispersion (a marker of torsadogenicity) is also affected during LTI by analysing parameters such as the Tp-e interval (interval between the peak to the end of the T-wave) and Tp-e/QTc (rate corrected Tp-e interval).Trial registration numberCRD42018090282.

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Section: Resultssupporting

confidence: 74%