title: Effects of conventional vs high-dose rocuronium on the QTc interval during anesthesia induction and intubation in patients undergoing coronary artery surgery: a randomized, double-blind, parallel trial.
abstract: Myocardial ischemia, as well as the induction agents used in anesthesia, may cause corrected QT interval (QTc) prolongation. The objective of this randomized, double-blind trial was to determine the effects of high- vs conventional-dose bolus rocuronium on QTc duration and the incidence of dysrhythmias following anesthesia induction and intubation. Fifty patients about to undergo coronary artery surgery were randomly allocated to receive conventional-dose (0.6 mg/kg, group C, n=25) or high-dose (1.2 mg/kg, group H, n=25) rocuronium after induction with etomidate and fentanyl. QTc, heart rate, and mean arterial pressure were recorded before induction (T0), after induction (T1), after rocuronium (just before laryngoscopy; T2), 2 min after intubation (T3), and 5 min after intubation (T4). The occurrence of dysrhythmias was recorded. In both groups, QTc was significantly longer at T3 than at baseline [475 vs 429 ms in group C (P=0.001), and 459 vs 434 ms in group H (P=0.005)]. The incidence of dysrhythmias in group C (28%) and in group H (24%) was similar. The QTc after high-dose rocuronium was not significantly longer than after conventional-dose rocuronium in patients about to undergo coronary artery surgery who were induced with etomidate and fentanyl. In both groups, compared with baseline, QTc was most prolonged at 2 min after intubation, suggesting that QTc prolongation may be due to the nociceptive stimulus of intubation.
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Öztürk
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Ağdanli
authors.affiliation: Department of Cardiology, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Ö
authors.initials: Ö
authors.lastname: Bayturan
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Çikrikci
authors.affiliation: Department of Anesthesiology and Reanimation, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: G T
authors.initials: GT
authors.lastname: Keleş
mesh_terms: D000368:Aged; D000732:Androstanols / Q000008:administration & dosage*; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D062186:Arterial Pressure / Q000187:drug effects; D003331:Coronary Vessels / Q000601:surgery*; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects*; D005045:Etomidate / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007440:Intubation / Q000009:adverse effects* / Q000379:methods; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D000077123:Rocuronium; D018709:Statistics, Nonparametric
chemical_list: D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D005283:Fentanyl; D000077123:Rocuronium; D005045:Etomidate