小于1 MAC的地氟醚对气管插管诱发的QT间期的影响
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Effect of desflurane at less than 1 MAC on QT interval prolongation induced by tracheal intubation
背景与目的
地氟醚的最低有效肺泡浓度（MAC）已被证明可延长QT间期，但尚不清楚在较低浓度下是否也是这种情况。 本研究的目的是确定地氟醚浓度＜1MAC是否影响气管插管诱导的QT间期延长。
方 法
四十四个受试者接受吸入1 MAC地氟烷，氧气100％，新鲜气体流速为6升/分钟（地氟醚组）或仅有氧气100％（对照组）。开始于异丙酚麻醉诱导，气管插管。 QT间隔由Bazett（QTcB）和Fridericia（QTcF）公式校正。 主要测量结果是气管插管后QTcB。 次要结果是T波峰值（Tp-e），平均动脉压（MAP），心率（HR）和双频指数（BIS）评分。
结 果
气管插管后即刻QTc间期在对照组和地氟烷组之间没有差异。 本研究中两组间Tp-e或HR无差异。 然而，在气管插管后1分钟，地氟醚组的MAP和BIS评分明显降低。
结 论
丙泊酚麻醉诱导后控制通气时吸入1MAC的地氟醚不影响气管插管引起的QTc延长。
原始文献摘要
Kim S H, Park S Y, Chae W S, et al. Effect of desflurane at less than 1 MAC on QT interval prolongation induced by tracheal intubation.[J]. British Journal of Anaesthesia, 2010, 104(2):150-157.
Background. Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of ,1MAC affect tracheal intubation-induced prolongation of the QT interval.
Methods. Forty-four subjects received either inspired desflurane at 1 MAC in oxygen 100% at a fresh gas flow rate of 6 litre min 21 (desflurane group) or only oxygen 100% (control group)
beginning at anaesthesia induction with propofol, before tracheal intubation. The QT intervals were corrected by Bazett’s (QTcB) and Fridericia’s (QTcF) formulae. The primary outcome
was the QTcB immediately after tracheal intubation. Secondary outcomes were the interval from the peak to the end of the T wave (Tp–e), mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) score.
Results. The QTc interval immediately after tracheal intubation did not differ between the control and the desflurane groups [QTcB, 451 ( SD 23) vs 456 (27) ms, P¼0.56; QTcF, 422 (24) vs 429 (22) ms, P¼0.31, control vs desflurane group, respectively]. There was no difference in Tp–e or HR between the two groups in this study. However, MAP and the BIS score were significantly lower in the desflurane group until 1 min after tracheal intubation.
Conclusions. The administration of desflurane at an inspiratory concentration of 1 MAC during manually controlled ventilation after anaesthesia induction with propofol did not affect tracheal intubation-induced QTc prolongation.
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