Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-24T02:59:16.268Z Has data issue: false hasContentIssue false

The effects of sevoflurane, isoflurane and desflurane on QT interval of the ECG

Published online by Cambridge University Press:  23 December 2004

H. Yildirim
Affiliation:
Atatürk Teaching Hospital, Department of Anaesthesiology, Izmir, Turkey
T. Adanir
Affiliation:
Atatürk Teaching Hospital, Department of Anaesthesiology, Izmir, Turkey
A. Atay
Affiliation:
Atatürk Teaching Hospital, Department of Anaesthesiology, Izmir, Turkey
K. Katircioğlu
Affiliation:
Atatürk Teaching Hospital, Department of Anaesthesiology, Izmir, Turkey
S. Savaci
Affiliation:
Atatürk Teaching Hospital, Department of Anaesthesiology, Izmir, Turkey
Get access

Extract

Summary

Background and objective: To determine if there is any significant difference between the effects of desflurane, isoflurane and sevoflurane on the QT interval, QT dispersion, heart rate corrected QT interval and QTc dispersion of the electrocardiogram.

Methods: The study was conducted in a prospective, double blind and randomized manner in a teaching hospital. Ninety ASA I patients, aged 16–50 yr, undergoing general anaesthesia for noncardiac surgery were studied.

Results: There was no significant change in QT intervals during the study in any group (P > 0.05). QT dispersion in the sevoflurane group 49 ± 14 ms vs. 37 ± 10 ms; in the desflurane group 55 ± 16 and 62 ± 21 ms vs. 35 ± 14 ms and in the isoflurane group 54 ± 26 and 59 ± 24 ms vs. 42 ± 19 ms were significantly increased at 3 and 10 min after 1 MAC of steady end-tidal anaesthetic concentration compared with baseline values (P < 0.05). QTc values in the sevoflurane group were 444 ± 24 and 435 ± 21ms vs. 413 ± 19 ms (P < 0.05), in the isoflurane group were 450 ± 26 and 455 ± 34 ms vs. 416 ± 34 ms (P < 0.05), in the desflurane group were 450 ± 26 and 455 ± 34 ms vs. 416 ± 34 ms (P < 0.05) at 3 and 10 min after reaching 1 MAC of anaesthetic concentration and significantly increased compared with baseline values. QTc dispersion increased significantly with sevoflurane 62 ± 14 ms vs. 45 ± 16 ms (P < 0.05); isoflurane 70 ± 36 ms at 3 min and 75 ± 36 ms at 10 min after reaching 1 MAC of anaesthetic concentration vs. 50 ± 24 ms (P < 0.05); desflurane 67 ± 25 ms at 3 min and 74 ± 27 ms at 10 min after 1 MAC concentration vs. 41 ± 22 ms (P < 0.05).

Conclusion: Sevoflurane, isoflurane and desflurane all prolonged QTd, QTc and QTcd but there were no significant intergroup differences.

Type
Original Article
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Batchvarov V, Malik M. Measurement and interpretation of QT dispersion. Prog Cardiovasc Dis 2000; 42: 325344.Google Scholar
Schwartz PJ, Stramba BM. Prolongation of the QT interval and the sudden infant death syndrome. New Engl J Med 1998; 338: 17091714.Google Scholar
Abe K, Takada K, Yoshia I. Intraoperative torsades des pointes ventricular tachycardia and ventricular fibrillation during sevoflurane anesthesia. Anesth Analg 1998; 86: 4.Google Scholar
Lindgren L. ECG changes during halothane and enflurane anesthesia for ENT surgery in children. Br J Anaesth 1981; 53: 653662.Google Scholar
Fukuda H, Hirabayashi Y, Shimizu R, Saitoh K, Mitsuhata H. Sevoflurane is equivalent to isoflurane for attenuating bupivacaine induced arrhythmias and seizures in rats. Anesth Analg 1996; 83: 570573.Google Scholar
Schouten EG, Dekker JM, Meppelink P, Kok FJ, Vandenbroucke JP, Pool J. QT interval prolongation predicts cardiovascular mortality in an apparently healthy population. Circulation 1991; 84: 15161523.Google Scholar
O’Leary E, Hubbard K, Tormey W, Cunningham AJ. Laparoscopic cholecystectomy: hemodynamic and neuroendocrine responses after pneumoperitoneum. Br J Anaesth 1996; 76: 640644.Google Scholar
de Bruyne MC, Hoes AW, Kors JA, Hofman A, van Bemmel JH, Grobbee DE. QTc dispersion predicts cardiac mortality in the elderly. Circulation 1998; 97: 467472.Google Scholar
Saarnivaara L, Klemola UM, Lindgren L, Rautiainen P, Suvanto A. QT Interval of the ECG, heart rate and arterial pressure using propofol methohexital or midazolam for induction of anaesthesia. Acta Anaesthesiol Scand 1990; 34: 276281.Google Scholar
Özkoçak I, Kirdemir P, Demirbilek S, et al. Laparoskopik girişimlerde QT mesafesi değişiklikleri. Türk Anest Rea Cem Mecmuasi 1999; 27: 186189.Google Scholar
Michaloudis D, Fraidakis O, Lefaki T, et al. Anaesthesia and the QT interval in humans. The effects of isoflurane and halothane. Anaesthesia 1996; 51: 219224.Google Scholar
Schmeling WT, Warltier DC, McDonald DJ, Madsen KE, Atlee JL, Kampine JP. Prolongation of the QT interval by enflurane, isoflurane and halothane in humans. Anesth Analg 1991; 72: 137144.Google Scholar
Kleinsasser A, Kuenszberg E, Loeckinger A, et al. Sevoflurane but not propofol, significantly prolongs the QT interval. Anesth Analg 2000; 90: 2527.Google Scholar
Güler N, Kati I, Demirel B, Bilge M, Eryonucu B, Topal C. The effects of volatile anesthetics on the QTc interval. J Cardiothor Vasc Anesth 2001; 15: 188191.Google Scholar
Güler N, Bilge M, Eryonucu B, Kati I, Demirel CB. The effects of halothane and sevoflurane on QT dispersion. Acta Cardiol 1999; 54: 311315.Google Scholar