QT interval, heart rate and arterial pressures using propofol, thiopentone or methohexitone for induction of anaesthesia in children.
The effects on corrected QT interval (QTc), heart rate and arterial pressure were studied after induction with propofol 1.5, 2 or 2.5 mg.kg-1, thiopentone 5 mg.kg-1 or methohexitone 2 mg.kg-1 in 123 ASA class I or II children undergoing outpatient otolaryngological surgery. Premedication consisted of oral midazolam and atropine. The children were randomly allocated to one of the three propofol groups or to the thiopentone or methohexitone group. After injection of the intravenous anaesthetic, the QTc interval was significantly prolonged after propofol 2.5 mg.kg-1. Thirty seconds after suxamethonium 1.5 mg.kg-1, a significant prolongation of the QTc interval occurred in the thiopentone and propofol 1.5 and 2 mg.kg-1 groups. After intubation, no further prolongation of the QTc interval occurred in any of the groups. Heart rate increased significantly after the barbiturates but not after propofol. Systolic arterial pressure decreased significantly after propofol 1.5 and 2.5 mg.kg-1. In all groups a cardiovascular intubation response occurred. Bradycardia and junctional rhythm occurred in 4% of the children in both barbiturate groups and in 19-29% in the propofol groups. It is concluded that propofol causes prolongation of the QT interval and results in a higher incidence of bradycardia and junctional rhythm than the barbiturates.
Saarnivaara
L
L
Department of Anaesthesia, Otolaryngological Hospital, Helsinki University Central Hospital, Finland.
Hiller
A
A
Oikkonen
M
M
D000771:Anesthesia, Intravenous; D001285:Atropine / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D001919:Bradycardia / Q000139:chemically induced; D002675:Child, Preschool; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008723:Methohexital / Q000008:administration & dosage / Q000494:pharmacology*; D008874:Midazolam / Q000008:administration & dosage; D011229:Preanesthetic Medication; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D013390:Succinylcholine / Q000494:pharmacology; D013874:Thiopental / Q000008:administration & dosage / Q000494:pharmacology*
D001285:Atropine; D008723:Methohexital; D013390:Succinylcholine; D013874:Thiopental; D008874:Midazolam; D015742:Propofol