Comparison of single-breath vital capacity rapid inhalation with sevoflurane 5% and propofol induction on QT interval and haemodynamics for laparoscopic surgery.
OBJECTIVE
To compare two techniques to achieve induction of anaesthesia for laparoscopic surgery. A single-breath vital capacity rapid inhalation induction with sevoflurane was compared to intravenous propofol. Their effects on haemodynamics and the QT interval of the electrocardiogram were assessed.


METHODS
Forty-four ASA I-II patients scheduled to undergo elective laparoscopic gynaecological surgery were divided into two groups. In the sevoflurane group (Group S, n = 22), general anaesthesia was induced with a single-breath vital capacity rapid inhalation of sevoflurane 5% with nitrous oxide (N2O) 65% in O2 and then anaesthesia was maintained with sevoflurane 1-1.5% with N2O 65% in O2. In the propofol group (Group P, n = 22), general anaesthesia was induced with propofol 2 mg kg(-1) intravenously and maintained with propofol 6 mg kg(-1) h(-1). Systolic, diastolic and mean arterial pressures, heart rate and end-tidal CO2 values were recorded before anaesthesia (basic value), during the induction period (time X), at 10 min (time Y) and at 30 min (time Z) of CO2 insufflation in all patients. QT intervals were calculated using Bazett's equation.


RESULTS
Systolic, diastolic and mean arterial pressure values during the induction period (time X) were lower than the basic value in both groups (P < 0.05). In Group S, QTc intervals were significantly longer during the induction period (time X) and at the tenth min of CO2 insufflation (time Y) than Group P (P < 0.05). Five patients at time X and two patients at time Y developed ventricular dysrhythmias, which improved spontaneously in Group S. In Group P, there was no significant difference in QTc intervals and only one patient developed a ventricular dysrhythmia at time Y.


CONCLUSIONS
Single-breath vital capacity rapid inhalation induction technique with sevoflurane can cause prolongation of the QT interval and dysrhythmias, compared with induction and maintenance of anaesthesia with propofol in laparoscopic surgery.
Adnan Menderes University, Department of Anesthesiology, Aydin, Turkey. uzmdrsenselda@mynet.com
S
S
Sen
G
G
Ozmert
N
N
Boran
H
H
Turan
E
E
Caliskan
D000328:Adult; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D010535:Laparoscopy; D008738:Methyl Ethers / Q000008:administration & dosage* / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane; D014797:Vital Capacity
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol