The effects of sevoflurane and desflurane anesthesia on QTc interval and cardiac rhythm in children.
BACKGROUND
Inhalational anesthetics may prolong QTc interval (QT interval corrected for heart rate) of the ECG and cause life-threatening arrythmias. The effects of desflurane on QTc interval and cardiac rhythm have not been reported previously in children. We assessed the effects of desflurane anesthesia on QTc interval and cardiac rhythm and compared them with sevoflurane anesthesia in children.


METHODS
The study was performed on 20 children admitted for inguinal hernia repair, with normal QTc intervals. Anesthesia was induced with propofol and intubation was achieved with vecuronium. Anesthesia was maintained with 2% sevoflurane (group I, n = 11) or 6% desflurane (group II, n = 9) and 66% nitrous oxide in oxygen. Electrocardiogram recordings were obtained by Holter recorder. QTc intervals were measured at baseline, 5, 10, 15, and 30 min after inhalation.


RESULTS
None of the patients had significant arrythmia with desflurane anesthesia. One patient in the sevoflurane group had single, bigemini and multiform ventricular extrasystoles. There was no statistically significant difference in the baseline QTc values of the groups. Desflurane significantly prolonged QTc interval 5 min after induction until 30 min of anesthesia compared with baseline values (P = 0.029), while no significant prolongation was observed with sevoflurane (P = 0.141).


CONCLUSIONS
Use of 2% sevoflurane during maintenance of anesthesia does not significantly prolong QTc interval while 6% desflurane significantly prolonged QTc interval in children with normal QTc interval undergoing inguinal herniorrhaphy.
Aypar
Ebru
E
Section of Pediatric Cardiology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Karagoz
Ayse Heves
AH
Ozer
Sema
S
Celiker
Alpay
A
Ocal
Turgay
T
D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002648:Child; D002675:Child, Preschool; D000077335:Desflurane; D015716:Electrocardiography, Ambulatory / Q000187:drug effects / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000379:methods; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects / Q000494:pharmacology*; D016343:Monitoring, Intraoperative / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D009609:Nitrous Oxide / Q000008:administration & dosage; D000077149:Sevoflurane; D013997:Time Factors; D014673:Vecuronium Bromide / Q000008:administration & dosage
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D014673:Vecuronium Bromide; D000077335:Desflurane; D007530:Isoflurane; D009609:Nitrous Oxide