Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T06:53:10.024Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of single-breath vital capacity rapid inhalation with sevoflurane 5% and propofol induction on QT interval and haemodynamics for laparoscopic surgery

Published online by Cambridge University Press:  23 December 2004

S. Sen ,
G. Ozmert ,
N. Boran ,
H. Turan  and
E. Caliskan
S. Sen
Affiliation:
Adnan Menderes University, Department of Anesthesiology, Aydin, Turkey
G. Ozmert
Affiliation:
SSK Ankara Maternity and Women's Health Teaching Hospital Etlik, Ankara, Turkey
N. Boran
Affiliation:
SSK Ankara Maternity and Women's Health Teaching Hospital Etlik, Ankara, Turkey
H. Turan
Affiliation:
SSK Ankara Maternity and Women's Health Teaching Hospital Etlik, Ankara, Turkey
E. Caliskan
Affiliation:
SSK Ankara Maternity and Women's Health Teaching Hospital Etlik, Ankara, Turkey
Get access

Extract

Summary

Background and objective: To compare two techniques to achieve induction of anaesthesia for laparoscopic surgery. A single-breath vital capacity rapid inhalation induction with sevoflurane was compared to intravenous propofol. Their effects on haemodynamics and the QT interval of the electrocardiogram were assessed.

Methods: Forty-four ASA I–II patients scheduled to undergo elective laparoscopic gynaecological surgery were divided into two groups. In the sevoflurane group (Group S, n = 22), general anaesthesia was induced with a single-breath vital capacity rapid inhalation of sevoflurane 5% with nitrous oxide (N2O) 65% in O2 and then anaesthesia was maintained with sevoflurane 1–1.5% with N2O 65% in O2. In the propofol group (Group P, n = 22), general anaesthesia was induced with propofol 2 mg kg−1 intravenously and maintained with propofol 6 mg kg−1 h−1 . Systolic, diastolic and mean arterial pressures, heart rate and end-tidal CO2 values were recorded before anaesthesia (basic value), during the induction period (time X), at 10 min (time Y) and at 30 min (time Z) of CO2 insufflation in all patients. QT intervals were calculated using Bazett's equation.

Results: Systolic, diastolic and mean arterial pressure values during the induction period (time X) were lower than the basic value in both groups (P < 0.05). In Group S, QTc intervals were significantly longer during the induction period (time X) and at the tenth min of CO2 insufflation (time Y) than Group P (P < 0.05). Five patients at time X and two patients at time Y developed ventricular dysrhythmias, which improved spontaneously in Group S. In Group P, there was no significant difference in QTc intervals and only one patient developed a ventricular dysrhythmia at time Y.

Conclusions: Single-breath vital capacity rapid inhalation induction technique with sevoflurane can cause prolongation of the QT interval and dysrhythmias, compared with induction and maintenance of anaesthesia with propofol in laparoscopic surgery.

Keywords

ANAESTHETICS, INHALATIONAL, sevofluraneANAESTHETICS, INTRAVENOUS, propofolELECTROCARDIOGRAPHY, QT intervalLAPAROSCOPY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 7 , July 2004 , pp. 543 - 546
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

Agnor MD, Sikich N, Lerman J. Single breath vital capacity rapid inhalation induction in children 8% sevoflurane versus 5% halothane. Anesthesiology 1998; 89: 379–384.Google Scholar
Philip BK, Lombard L, Roaf ER, Drager LR, Calalang I, Philip JH. Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anesthesia. Anesth Analg 1999; 89: 623–627.Google Scholar
Schmeling WT, Warltier DC, McDonald DJ. Prolongation of the QT interval by enflurane, isoflurane, and halothane in humans. Anesth Analg 1991; 72: 137–144.Google Scholar
Wisely NA, Shipton EA. Long QT syndrome and anaesthesia. Eur J Anaesthesiol 2002; 19: 853–859.Google Scholar
Kleinsasser A, Kuenzberg E, Loeckinger A. Sevoflurane but not propofol, significantly prolongs the QT interval. Anesth Analg 2000; 90: 25–27.Google Scholar
Kuenzberg E, Loeckinger A, Kleinssasser A. Sevoflurane progressively prolongs the QT interval in unpremedicated female adults. Eur J Anaesthesiol 2000; 17: 662–664.Google Scholar
Gallagher JD, Weindling SN, Anderson G, Fillinger MP. Effect of sevoflurane on QT interval in a patient with congenital long QT syndrome. Anesthesiology 1998; 89: 1569–1573.Google Scholar
Abe K, Takada K, Yoshiya I. Intraoperative Torsade de Pointes ventricular tachycardia and ventricular fibrillation during sevoflurane anesthesia. Anesth Analg 1998; 86: 701–702.Google Scholar
Galletly DC, Tobin PD. Effects of inhalation of 30% nitrous oxide on spectral components of heart rate variability in conscious man. Clin Sci 1993; 85: 389–392.Google Scholar
Hashimoto H, Imamura S, Watanabe S, et al. Electrophysiologic effects of nitrous oxide, a volatile anesthetic, in dogs following myocardial infarction in comparison with other anesthetics. Biol Pharm Bull 1997; 20: 82–85.Google Scholar
Nakatsuka I, Ochiai R, Takeda J. Changes in heart rate variability in sevoflurane and nitrous oxide anesthesia: effects of respiration and depth of anesthesia. J Clin Anesth 2002; 14: 196–200.Google Scholar
Michaloudis D. The effects of midazolam or propofol followed by suxamethonium on this QT interval in humans. Eur J Anaesthesiol 1996; 13: 364–368.
Kleinsasser A, Loeckinger A, Lindner KN, Boehler M, Puehringer F, Keller C. Reversing sevoflurane-associated Q-Tc prolongation by changing to propofol. Anaesthesia 2001; 56: 248–250.Google Scholar
Cunningham AJ, Brull SJ. Laparoscopic cholecystectomy: anesthetic implications. Anesth Analg 1993; 76: 1120–1123.Google Scholar
Chui PT, Gin T, Oh TE. Anaesthesia for laparoscopic general surgery. Anaesth Intensive Care 1993; 21: 163–171.Google Scholar