Effect of anaesthetic agents on p-wave dispersion on the electrocardiogram: comparison of propofol and desflurane.
Anaesthetics influence cardiac electrical activity by various mechanisms; thus, they may have pro-arrhythmic or anti-arrhythmic actions. Increased P-wave dispersion is associated with a risk of paroxysmal atrial fibrillation. The aim of the present study was to analyse the impact of propofol and desflurane on changes in P wave dispersion, which may reflect the anti-arrhythmic effects of these drugs. Fifty patients undergoing scheduled surgery were included in the study. Patients were divided into two equal groups: a propofol group and a desflurane group. Patients in the propofol group were initially administered 2.5 mg/kg propofol, followed by infusion of 6 mg/kg per h propofol. Anaesthesia in the desflurane group was achieved using inhalation induction, with concentrations up to 8-12.5 vol%. When signs of adequate anaesthesia were observed, the concentration of desflurane was reduced to 6 vol%. An electrocardiogram (ECG) was obtained before induction and then again 1, 3 and 5 min after the initiation of propofol infusion or the induction of anaesthesia in the desflurane group; additional measurements were performed after tracheal intubation. P-wave dispersion was assessed by differences in maximal and minimal P-wave duration on a 12-lead ECG. P-wave dispersion did not change over time in the desflurane group. In the propofol group, there was a significant decrease in P-wave dispersion after 3 and 5 min of anaesthesia. Significant differences were observed between study groups after 1, 3 and 5 min of anaesthesia, and disappeared after tracheal intubation. Mean and maximal P-wave duration did not change in either group. In conclusion, propofol decreases P-wave dispersion and this seems to be connected with the anti-arrhythmic properties of the drug.
Owczuk
Radoslaw
R
Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Poland. r.owczuk@amg.gda.pl
Wujtewicz
Magdalena A
MA
Sawicka
Wioletta
W
Polak-Krzeminska
Agnieszka
A
Suszynska-Mosiewicz
Aleksandra
A
Raczynska
Krystyna
K
Wujtewicz
Maria
M
D000328:Adult; D000777:Anesthetics / Q000494:pharmacology*; D000077335:Desflurane; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000494:pharmacology*; D055815:Young Adult
D000777:Anesthetics; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol