The effects of volatile induction and maintenance of anesthesia and selective spinal anesthesia on QT interval, QT dispersion, and arrhythmia incidence.
OBJECTIVE
The effects of sevoflurane general anesthesia and bupivacaine selective spinal anesthesia on QT dispersion (QTd) and corrected QT (QTc) interval were investigated.


METHODS
This prospective, randomized, double-blind study was conducted between July and September 2009 in the Urology and General Surgery operating rooms. Forty ASA I-II patients undergoing noncardiac surgery were randomized into two groups: Group R (n=20) and Group V (n=20). In Group R, 5 mg bupivacaine was administered into the spinal space. Anesthesia induction in Group V was established with sevoflurane + 0.1 mg/kg vecuronium using the maximum vital capacity technique. Anesthesia was maintained with 2-3% sevoflurane + 50% N2O/O2 inhalation. All patients were tested with a 24-hour Holter ECG device. QT, QTc, and QTd intervals were measured using 12-lead ECG records at 1 and 3 minutes during preinduction, postinduction, postincision and postextubation periods. Mean arterial pressure (MAP), heart rate and ECG records were measured simultaneously.


RESULTS
None of the patients displayed arrhythmia. There was no significant difference between the groups with regard to QTd values (p>0.05). However, QTc was longer in Group V than in Group R after the induction of anesthesia at 3 minutes, after the intubation at 1 and 3 minutes, and after the incision at 1 and 3 minutes. MAP and heart rate were generally higher in Group V (p<0.05).


CONCLUSIONS
Although Volatile Induction and Maintenance of Anesthesia (VIMA) with sevoflurane might prolong the QTc interval and did not result in arrhythmia, selective spinal anesthesia with bupivacaine was not associated with alterations in the QT interval or arrhythmia.
Ornek
Ender
E
Department of Cardiology, Etlik Ihtisas Education and Training Hospital, Ankara, Turkey.
Ornek
Dilsen
D
Alkent
Z Peren
ZP
Ekin
Abdülselam
A
Basaran
Meleksah
M
Dikmen
Bayazit
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D002045:Bupivacaine / Q000009:adverse effects*; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D000077149:Sevoflurane; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D055815:Young Adult
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D008738:Methyl Ethers; D000077149:Sevoflurane; D002045:Bupivacaine