Prolongation of the Q-T Interval and Sudden Cardiac Arrest Following Right Radical Neck Dissection

Otteni, J.C.; Pottecher, T; Bronner, Gila; Flesch, H.; Diebolt, J. R.

doi:10.1097/00000542-198310000-00019

Cited by 34 publications

(10 citation statements)

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“…The hypothesis of left-sided sympathetic predominance is supported by animal studies which show that stimulation of the left stellate ganglion or blockade of the right sympathetic ganglion provokes prolongation of the QT interval and increased susceptibility to ventricular dysrhythmias (Yanowitz, Preston & Abildskov 1966). In humans, left stellate ganglion stimulation or right stellate ganglion blockade can produce prolongation of the QT interval (Crampton 1979;Otteni et al 1983). In patients with LQTS, left stellate ganglion block has been used therapeutically to shorten the QT interval (Moss & McDonald 1971;Yanagida, Kemi & Suwa 1976;Bhandari et al 1984).…”

Section: Discussionmentioning

confidence: 99%

Esmolol in the anaesthetic management of a boy with Romano–Ward syndrome

Dunn

Gunter

Quattromani

et al. 1991

Pediatric Anesthesia

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The Romano-Ward syndrome is a congenital form of long Q-T syndrome which frequently causes syncope, dysrhythmias and sudden death. Certain anaesthetic drugs can precipitate dangerous dysrhythmias. Chronic P-adrenergic blockade is the therapy of choice for symptomatic patients and establishment of complete and total P-blockade is recommended for symptomatic patients having anaesthesia and surgery. We report the successful use of esmolol to establish rapid and total P-blockade before a short elective out-patient procedure and suggest that esmolol may be useful for other patients with Romano-Ward syndrome having anaesthesia and surgery.

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Section: Discussionmentioning

confidence: 99%

Esmolol in the anaesthetic management of a boy with Romano–Ward syndrome

Dunn

Gunter

Quattromani

et al. 1991

Pediatric Anesthesia

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“…In the study of Acquadro et al [47], a QT interval above 440 ms occurred in 76% of the patients after right neck dissection and in 44% of the patients after left neck dissection or without neck dissection. In the study of Otteni et al [48], three patients presented torsades de pointe after right neck dissection (two of them had hypokaliemia, and the other suddenly deceased on the tenth postoperative day without explanation), but no cardiac dysrhythmia was observed after left neck dissection. Torsade de pointe was not reported in the other studies, but the number of patients included was low.…”

Section: Cardiac Rhythm Abnormalitiesmentioning

confidence: 96%

“…After right neck dissection, a QT interval increase was first reported in 1967 [46]. After neck dissection, most of the studies found an increase of the QT interval, which was more important after right dissection [42,47,48] (Fig. 1).…”

Section: Cardiac Rhythm Abnormalitiesmentioning

confidence: 99%

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Sudden death after major head and neck surgery

Guéret

Bourgain

Luboinski

2006

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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In more recent studies, the mortality rate after neck dissection was below 4%, which is at a lower value than reported in previous studies. Sudden deaths have been described, however, mainly during the first three postoperative days. Alcoholism and perioperative hypotension are two predictive factors for cardiac complications. Careful follow-up of these patients during the early postoperative period should be performed to reduce the mortality by shortening the delay of care.

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“…11 Procainamide and lidocaine have been thought to be contraindicated, due to their propensity to prolong the QT interval. 12 Nevertheless, lidocaine has been reported to successfully treat ventricular arrhythmias in LQTS. 13 The anesthetic management of these patients is controversial.…”

Section: Objectif : Le Syndrome Congénital Du Qt Long Est Caractérisémentioning

confidence: 99%

Ventricular tachycardia during general anesthesia in a patient with congenital long QT syndrome

Katz

Quijano

Barcelon

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Congenital long QT syndrome is characterized by a corrected QT interval of at least 440 msec on the electrocardiogram and has been associated with recurrent syncope, documented ventricular arrhythmia and sudden death. There have been numerous articles over the past 20 years describing isolated instances of surgical and anesthesia related complications but the general anesthetic management of the condition remains unclear.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : An 11-yr-old female with documented long QT syndrome, with two episodes of syncope in the past, was admitted for emergency drainage of left periorbital cellulitis. Anesthesia was induced with propofol, fentanyl and rocuronium, and initially maintained with nitrous oxide and halothane. After 20 min, the patient developed ventricular tachycardia (torsade de pointes). Lidocaine 1 mg·kg -1 iv was given and the rhythm reverted to normal sinus. Halothane was discontinued and the surgery proceeded without further incident.C Co on nc cl lu us si io on ns s: : Our review of the literature revealed that patients with long QT syndrome whose symptoms are well controlled prior to surgery tend to do well regardless of the anesthetic chosen. There are, however, theoretical reasons to avoid anesthetics which either sensitize the myocardium to catecholamines or which cause an increase in circulating levels of catecholamines.

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Prolongation of the Q-T Interval and Sudden Cardiac Arrest Following Right Radical Neck Dissection

Cited by 34 publications

References 0 publications

Esmolol in the anaesthetic management of a boy with Romano–Ward syndrome

Esmolol in the anaesthetic management of a boy with Romano–Ward syndrome

Sudden death after major head and neck surgery

Ventricular tachycardia during general anesthesia in a patient with congenital long QT syndrome

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