Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-20T03:19:23.591Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of inhalational anaesthetics on QTc interval

Published online by Cambridge University Press:  19 April 2005

A. H. Karagöz ,
E. Basgul ,
V. Celiker  and
U. Aypar
A. H. Karagöz
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
E. Basgul
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
V. Celiker
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
U. Aypar
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
Get access

Abstract

Summary

Background and objective: The aim of this study was to assess time dependent cumulative effects of three different inhalation anaesthetics on QTc interval during the maintenance of anaesthesia.

Method: Seventy-five ASA I–II male patients undergoing inguinal herniorrhaphy were randomly allocated into three groups. No premedication was given. Anaesthesia was induced with thiopental and tracheal intubation was facilitated by vecuronium in all groups. Anaesthesia was maintained with 0.8% halothane (Group I) (n = 25), 1% isoflurane (Group II) (n = 25), or 2% sevoflurane (Group III) (n = 25) and 66% nitrous oxide in oxygen. Three lead electrocardiogram recordings were taken before induction, 2, 5, 10, 15, 30 and 45 min after induction and after extubation. Heart rate, systolic, diastolic, mean arterial pressure and SPO2 were recorded at the same time. Heart rate and corrected QT interval were evaluated by using Bazett's formula. Multivariate analysis of variance for repeated measures was used to determine intergroup and intragroup differences.

Results: There was no statistically significant difference in the baseline QTc values of the groups. There was no difference between QTc values with halothane and sevoflurane. There was a difference between QTc values with isoflurane and those with the other two inhalation anaesthetics (P < 0.05). Although QTc values in the isoflurane group were higher at all times, the critical value of 440 ms was not exceeded.

Conclusion: We conclude that halothane 0.8%, isoflurane 1% and sevoflurane 2% do not prolong QTc interval.

Keywords

ANAESTHETICS, INHALATION, halothane, isoflurane, sevofluraneARRHYTHMIASLONG QT SYNDROME, drug induced
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 3 , March 2005 , pp. 171 - 174
Copyright
2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Park MK. Cardiac arrhythmias. In: Park MK, ed. Pediatric Cardiology for Practitioners.St Louis, USA: Mosby Inc, 2002: 347–348.
Schmeling WT, Warltier DC, McDonald DJ, Madsen KE, Atlee JL, Kampine JP. Prolongation of the QT interval by enflurane, isoflurane and halothane in humans. Anesth Analg 1991; 72: 137–144.Google Scholar
Michaloudis D, Fraidakis O, Petrou A, Gigourtsi C, Parthenakis F. Anaesthesia and the QT interval. Effects of isoflurane and halothane in unpremedicated children. Anaesthesia 1998; 53: 435–439.Google Scholar
Michaloudis D, Fraidakis O, Lefaki T, et al. Anaesthesia and the QT interval in humans: the effects of isoflurane and halothane. Anaesthesia 1996; 51: 219–224.Google Scholar
Kleinsasser A, Kuenszberg E, Loeckinger A, et al. Sevoflurane, but not propofol, significantly prolongs the QT interval. Anesth Analg 2000; 90: 25–27.Google Scholar
Abe K, Takada K, Yoshiya I. Intraoperative torsade de pointes ventricular tachycardia and ventricular fibrillation during sevoflurane anesthesia. Anesth Analg 1998; 86: 701–702.Google Scholar
Park MK. Electrocardiography. In: Park MK, ed. Pediatric Cardiology for Practitioners.St Louis, USA: Mosby Inc, 2002: 41.
Garson A Jr, Carboni MP. Ventricular Arrhythmias. In: Garson A Jr, Bricker JT, Fisher DJ, Neish SR, eds. The Science and Practice of Pediatric Cardiology.Pennsylvania, USA: Williams & Wilkins, 1998: 2145.
Booker PD, Whyte SD, Ladusans EJ. Long QT syndrome and anaesthesia. Br J Anaesth 2003; 90: 349–366.Google Scholar
Bazett HC. An analysis of the time-relations of electro-cardiograms. Heart 1920; 7: 353–370.Google Scholar
Kenny RA, Sutton R. The prolonged QT interval – a frequently unrecognized abnormality. Postgrad Med J 1985; 61: 379–386.Google Scholar
Larsen JA, Kadish AH. Effects of gender on cardiac arrhythmias. J Cardiovasc Electrophysiol 1998; 9: 655–664.Google Scholar
Kuenszberg E, Loeckinger A, Kleinsasser A, Lindner KH, Puehringer F, Hoermann C. Sevoflurane progressively prolongs the QT interval in unpremedicated female adults. Eur J Anaesthesiol 2000; 17: 662–664.Google Scholar
Saarnivaara L, Hiller A, Oikkonen M. QT interval, heart rate and arterial pressures using propofol, thiopentone or methohexitone for induction of anaesthesia in children. Acta Anaesthesiol Scand 1993; 37: 419–423.Google Scholar
Kleinsasser A, Loeckinger A, Lindner KH, Keller C, Boehler M, Puehringer F. Reversing sevoflurane-associated QTc prolongation by changing to propofol. Anaesthesia 2001; 56: 248–250.Google Scholar
Michaloudis DG, Kanakoudis FS, Petrou AM, Konstantinidou AS, Pollard BJ. The effects of midazolam or propofol followed by suxamethonium on the QT interval in humans. Eur J Anaesthesiol 1996; 13: 364–368.Google Scholar
Michaloudis D, Fraidakis O, Lefaki T, et al. Anaesthesia and the QT interval in humans. The effects of isoflurane and halothane. Anaesthesia 1996; 51: 219–224.Google Scholar