七氟烷麻醉诱导期间静脉麻醉药对QT间期的影响
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The effects of intravenous anesthetics on QT interval during anesthetic induction with sevoflurane
背景与目的：已知七氟醚延长QT间期。本研究旨在确定静脉麻醉药和七氟醚的相互作用对QT间期的影响。
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方法：该研究包括48例接受腰椎手术的患者。 患者接受3μg/ kg芬太尼，然后在给予芬太尼注射后2分钟随机分配给T组，其中他们接受5mg / kg 硫戊巴比妥或P组，其中他们接受1.5mg / kg丙泊酚， 麻醉诱导。意识丧失后立即施用维库溴铵（1.5mg / kg）和七氟醚（3％吸入浓度）在，维库溴铵注射后3分钟进行气管插管。芬太尼使用前（T1）、芬太尼使用后2分钟(T2)、插管前即刻（T3）和插管后2分钟（T4），记录心率（HR），平均动脉压（MAP）、双频指数评分（BIS）和12导联心电图上记录的心率校正QT（QTc）。
结果：两组患者在基线患者特征方面无显著差异。两组麻醉诱导后BIS和MAP显着降低。 T3时，T组的MAP高于P组，两组HR降低。 T组在麻醉诱导后QTc间期延长，但在P组任何时间点均未改变。T组麻醉诱导后QTc间期长于P组。
结论：我们的结论是注射丙泊酚可以改善与七氟醚麻醉诱导相关的QTc间期延长。
Yoshiaki Terao1 · Ushio Higashijima1 · Tomomi Toyoda1, et al. The effects of intravenous anesthetics on QT interval during anesthetic induction with sevofluranes.[J] J Anesth DOI 10.1007/s00540-016-2252-8
BACKGROUND:Sevoflurane is known to prolong the QT interval.This study aimed to determine the effect of the interaction between intravenous anesthetics and sevoflurane on the QT interval.
METHODS:The study included 48 patients who underw nt lumbar spine surgery. Patients received 3 μg/kg fentanyl and were then randomly allocated to either Group T,in which they received 5 mg/kg thiamylal, or Group P, in which they received 1.5 mg/kg propofol, at 2 min after administration of fentanyl injection for anesthetic induction.Vecuronium (1.5 mg/kg) and sevoflurane (3 % inhaled concentration) were administered immediately after loss of consciousness and tracheal intubation was performed 3 min after vecuronium injection. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and the heart rate-corrected QT (QTc) interval on a 12-lead electrocardiogram were recorded immediately before fentanyl administration (T1), 2 min after fentanyl injection (T2),immediately before intubation (T3), and 2 min after intubation(T4).
RESULTS:There were no significant differences between the two groups in baseline patient characteristics. BIS and MAP significantly decreased after anesthesia induction in both groups. At T3, MAP in Group T was higher than in Group P, while HR had reduced in both groups. The QTc interval was prolonged after anesthesia induction in Group T, but did not change at any time point in Group P. The QTc interval after anesthesia induction in Group T was longer than in Group P.
CONCLUSIONS:We concluded that an injection of propofol could counteract QTc interval prolongation associated with sevoflurane anesthesia induction.
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