Effects of four anticholinesterase‐anticholinergic combinations and tracheal extubation on QTc interval of the ECG, heart rate and arterial pressure

Abstract

On the basis of the present results, anticholinesterase-anticholinergic combinations should be avoided in patients having a long QT interval syndrome or a prolonged QT interval from other causes. In addition, the cardiovascular stimulation caused by tracheal extubation should also be avoided in these patients.

Effects of target concentration infusion of propofol and tracheal intubation on QTc interval*

“…Midazolam, has been reported to have no effect on the QTc interval [11,18], whereas anticholinergic drugs have been shown to prolong the QTc interval [19]. Hence, a study was conducted to determine the effect of propofol on the QTc interval when midazolam was used as a premedication [9].…”

Intraoperative management of critical arrhythmia

“…Succinylcholine significantly prolongs the QT interval and QTc, particularly with thiopental [2122], although most non-depolarizing neuromuscular blockers have not been associated with prolongation [23]. However, the combination of anticholinesterase and anticholinergics to reverse neuromuscular blockade causes transient but significant prolongation of QTc [2425]. On the other hand, sugammadex is relatively safe [2627].…”

Drug-associated arrhythmia in the military patient

“…There is likely a blockade of K + channels, along with increased parasympathetic activity and direct myocyte damage 48. Hypoxia, acidosis and electrolyte disturbance as a consequence of organophosphate poisoning will also contribute to the cardiac toxicity.…”

“…Hypoxia, acidosis and electrolyte disturbance as a consequence of organophosphate poisoning will also contribute to the cardiac toxicity. The QT prolongation may be exacerbated by treatment with oximes and atropine 47 48. Nerve agent pretreatment with cholinesterase inhibitors will also prolong QT 48…”