顺式阿曲库铵对麻醉诱导期间喉罩置入患者校正QT间期延长的影响
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Corrected QT interval prolongation during anesthetic induction for laryngeal mask airway insertion with or without cisatracurium
背景与目的：本研究目的是观察麻醉诱导期间喉罩置入患者校正QT（QTc）间期延长的发生率及顺式阿曲库铵对QTc间期的影响。
1
方法：将88名患者分为两组：顺式阿曲库铵组（n = 45）和非顺式阿曲库铵组（n = 43）。通过12导联动态心电图连续记录患者从病房到麻醉诱导后的QTc间期。
结果：在顺式阿曲库铵组中，患者到达手术室后QTc间期从417.9±27.9ms显著增加到451.6±32.5ms，且在休息15min后显著降低至432.4±32.5ms; 给予异丙酚和芬太尼之后再次显著增加到459.7±23.8毫秒。然而，顺式阿曲库铵注射后QTc间期缩短。在非顺式阿曲库铵组中，QTc间期在给予芬太尼和异丙酚之前与顺式阿曲库铵组相似的变化。
结论：当患者到达手术室即刻和给予异丙酚和芬太尼后，QTc间期显著延长。顺式阿曲库铵对喉罩置入患者的QTc间期没有影响。
Xuan C1, Wu N1, Li Y1, Sun X2, Zhang Q3, Ma H1.
Corrected QT interval prolongation during anesthetic induction for laryngeal mask airway insertion with or without cisatracurium.
J Int Med Res. 2018 May;46(5):1990-2000. doi: 10.1177/0300060518764185.
Objective: This study was performed to observe the occurrence of corrected QT (QTc) interval prolongation during anesthetic induction for laryngeal mask airway insertion and the effects of cisatracurium administration on the QTc interval.
Methods: Eighty-eight patients were assigned to two groups: the cisatracurium administration group (n=45) and non-cisatracurium administration group (n=43). The QTc interval was continuously
recorded by a 12-lead Holter electrocardiogram beginning in the hospital ward and continuing until after anesthetic induction.
Results: In the cisatracurium administration group, the QTc interval significantly increased from 417.9±27.9 to 451.6±32.5 ms after arrival in the operating room and significantly decreased to 432.4±32.5 ms after a 15-minute rest; it significantly increased to 459.7±23.8 ms again after
propofol and fentanyl injection. However, the QTc interval decreased after cisatracurium injection.In the non-cisatracurium administration group, the QTc interval initially showed changes similar to those in the cisatracurium group until fentanyl and propofol were injected.
Conclusions: The QTc interval was significantly prolonged on arrival in the operating room and after propofol and fentanyl injection. The QTc interval did not significantly change by laryngeal mask airway insertion regardless of the administration of cisatracurium.
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