title: The effects of a single bolus of remifentanil on corrected QT interval change during sevoflurane induction.
abstract: OBJECTIVE
  Opioids may affect changes in the corrected QT interval (QTc) during anesthetic induction. This study examine whether a single bolus of remifentanil would prolong QTc after laryngeal mask airway (LMA) insertion during sevoflurane induction.
  
  
  METHODS
  Forty women of American Society of Anesthesiologists physical status 1 (ASA PS1) undergoing gynecological surgery were studied. All patients were induced using three vital capacity inhalation inductions with 5% sevoflurane. Two minutes after induction, the inspiratory concentration of sevoflurane was reduced to 2%. Using double-blinded randomization, patients were allocated into one of two groups, receiving either saline (placebo group, n = 20) or 0.25 μg.kg⁻¹ remifentanil (remifentanil group, n = 20) over a period of thirty seconds. Sixty seconds later, LMA insertion was performed. Recordings were taken with a 12-lead electrocardiogram at baseline, 2 min after induction and 1 and 3 min after LMA insertion. QTc was calculated by Bazett's formula. The mean arterial pressure (MAP) and heart rate (HR) were also measured at each time point.
  
  
  RESULTS
  The QTc interval was significantly prolonged in the placebo group as compared to the remifentanil group at 1 min after LMA insertion (467.8 ± 16.5 vs. 442.7 ± 21.3 ms, p < 0.001). However, there was no significant difference in QTc at 3 min after LMA insertion between the two groups. MAP and HR were significantly higher in the placebo group (p < 0.001).
  
  
  CONCLUSIONS
  A single bolus of remifentanil is safe method to attenuate prolonged QTc associated with insertion of LMA.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.
authors.forename: Eun Sung
authors.initials: ES
authors.lastname: Kim
authors.forename: Hae Wone
authors.initials: HW
authors.lastname: Chang
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008738:Methyl Ethers / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology*; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil