Droperidol for perioperative sedation causes a transient prolongation of the QTc time in children under volatile anesthesia.
BACKGROUND
Droperidol is useful for postoperative sedation in infants and children after cardiac surgery because it provides sedation and akinesia with minimal respiratory depression. However, droperidol has been associated with QT prolongation and ventricular arrhythmias. We investigated, if neuroleptanalgesic doses of droperidol led to QT prolongation and cardiac arrhythmias in children undergoing cardiac surgery.


METHODS
We retrospectively analysed electrocardiogram rhythm strips that were obtained before and in time increments after a 100 microg x kg(-1) intravenous bolus of droperidol in 20 children undergoing cardiac surgery. The longest QT interval was determined in each ECG and corrected for heart rate (QTc). All arrhythmias were recorded.


RESULTS
Droperidol led to a significant increase in QTc time that was still present at 15 min but had resolved within 30 min after the bolus. No associated arrhythmias were observed.


CONCLUSIONS
The statistically significant prolongation of QTc time after a sedative dose of droperidol is of concern because it may increase the risk for malignant cardiac arrhythmias. A large, prospective study is necessary to identify the true risk for arrhythmias after droperidol in this patient population, but our study suggests that any arrhythmogenic risk, if present, will be very transient, since the increase in QTc time was limited to a period of less than 30 min after the bolus.
Stuth
Eckehard A E
EA
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA. estuth@mcw.edu
Stucke
Astrid G
AG
Cava
Joseph R
JR
Hoffman
George M
GM
Berens
Richard J
RJ
D000759:Adjuvants, Anesthesia / Q000009:adverse effects*; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000503:physiopathology; D006348:Cardiac Surgical Procedures; D004329:Droperidol / Q000009:adverse effects*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D007223:Infant; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D009458:Neuroleptanalgesia; D012189:Retrospective Studies
D000759:Adjuvants, Anesthesia; D004329:Droperidol