Effects of halothane or sevoflurane on QTc dispersion during volatile induction of anaesthesia in children

Michaloudis, D.; Petru, Ann; Georgopoulou, Georgia; Fraidakis, O.; Zoubrouli, A.; Kafkalaki, K.; Geromarkaki, Elisavet; Markantoni, S.; Agouridakis, Panagiotis; Charissis, G.; Askitopoulou, H.

doi:10.1097/00003643-200000002-00151

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“…Michaloudis et al applied VIMA with sevoflurane and isoflurane and found that isoflurane prolonged the QTc interval but did not change QTd or QTcd, whereas sevoflurane did not affect those three parameters; overall, they determined that sevoflurane was a good agent. 9 Guler et al showed that sevoflurane, isoflurane, and halothane prolonged QTd and QTcd in patients who had no congenital heart disease. However, they found no statistically significant difference between the agents and concluded that those anesthetic agents caused myocardial repolarization abnormalities by increasing QTcd.…”

Section: Discussionmentioning

confidence: 99%

The effects of volatile induction and maintenance of anesthesia and selective spinal anesthesia on QT interval, QT dispersion, and arrhythmia incidence

Azevedo¹,

Azevedo²,

Lucena³

et al. 2010

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OBJECTIVE:The effects of sevoflurane general anesthesia and bupivacaine selective spinal anesthesia on QT dispersion (QTd) and corrected QT (QTc) interval were investigated.METHODS AND MATERIALS:This prospective, randomized, double-blind study was conducted between July and September 2009 in the Urology and General Surgery operating rooms. Forty ASA I–II patients undergoing noncardiac surgery were randomized into two groups: Group R (n = 20) and Group V (n = 20). In Group R, 5 mg bupivacaine was administered into the spinal space. Anesthesia induction in Group V was established with sevoflurane + 0.1 mg/kg vecuronium using the maximum vital capacity technique. Anesthesia was maintained with 2–3% sevoflurane + 50% N2O/O2 inhalation. All patients were tested with a 24-hour Holter ECG device. QT, QTc, and QTd intervals were measured using 12-lead ECG records at 1 and 3 minutes during preinduction, postinduction, postincision and postextubation periods. Mean arterial pressure (MAP), heart rate and ECG records were measured simultaneously.RESULTS:None of the patients displayed arrhythmia. There was no significant difference between the groups with regard to QTd values (p>0.05). However, QTc was longer in Group V than in Group R after the induction of anesthesia at 3 minutes, after the intubation at 1 and 3 minutes, and after the incision at 1 and 3 minutes. MAP and heart rate were generally higher in Group V (p<0.05).CONCLUSION:Although Volatile Induction and Maintenance of Anesthesia (VIMA) with sevoflurane might prolong the QTc interval and did not result in arrhythmia, selective spinal anesthesia with bupivacaine was not associated with alterations in the QT interval or arrhythmia.

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Section: Discussionmentioning

confidence: 99%