Influence of spinal anesthesia on corrected QT interval
Influence of spinal anesthesia on corrected QT interval
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DOI：
10.1016/j.rapm.2005.06.005
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发表时间：
2005-11-01
影响因子：
5.1
通讯作者：
Wujtewicz, M
中科院分区：
文献类型：
--
作者：
Owczuk, R;Sawicka, W;Wujtewicz, M
背景和目标：QT间期延长可能导致严重心律失常、多形性室性心动过速（“尖端扭转型室性心动过速”）和室颤。我们评估了脊髓麻醉对QTc间期的影响以及这种麻醉方法的潜在心律失常性。研究方法：对20例未经术前用药的男性患者进行评估，1例或11例美国麻醉医师协会的身体状况，他们接受了择期手术的脊髓麻醉。在脊髓麻醉前以及充分阻滞1、3、5和15分钟后测量QTc间期、心率和动脉压。结果如下：在阻滞后的第一分钟和随后的测量中观察到QTc间期（与初始值相比）统计学显著延长。阻滞开始后QTc间期的平均值之间未观察到差异。未观察到心率的显著变化。从第3分钟开始，与基线相比，观察到收缩压、舒张压和平均动脉压显著降低。在整个研究期间，收缩压、舒张压和平均动脉压持续降低。没有一名患者发生具有临床意义的心律失常。结论：脊髓麻醉引起无心血管疾病患者的QTc间期显著延长。
Background and Objectives: Prolongation of the QT interval may result in grave cardiac arrhythmias, polymorphic ventricular tachycardia ("torsades de pointes"), and ventricular fibrillation. We assessed the influence of spinal anesthesia on the QTc interval and the potential arrhythmogenicity of this method of anesthesia. Methods: Assessment was performed in 20 male unpremedicated patients, 1 or 11 American Society of Anesthesiologists physical status, who underwent spinal anesthesia for elective surgical procedures. Values of the QTc interval, heart rate, and arterial pressure were measured before spinal anesthesia as well as after 1, 3, 5, and 15 minutes of adequate blockade. Results: Statistically significant lengthening of the QTc interval (compared with initial values) was observed in the first minute after blockade and in subsequent measurements. No differences were observed between mean values of the QTc interval after the onset of blockade. No significant changes in heart rate were noted. From the third minute on, significant decreases of the systolic, diastolic, and mean arterial blood pressure were observed as compared with baseline. These decreases in systolic, diastolic, and mean arterial blood pressure persisted for the entire study duration. No one patient developed clinically important cardiac arrhythmias. Conclusions: Spinal anesthesia provokes significant QTc interval prolongation in patients without cardiovascular disorders.