Effects of long periods of pneumoperitoneum combined with the head-up position on heart rate-corrected QT interval during robotic gastrectomy: an observational study.
Effects of long periods of pneumoperitoneum combined with the head-up position on heart rate-corrected QT interval during robotic gastrectomy: an observational study.
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DOI：
10.1177/0300060518786914
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Kim HJ
中科院分区：
文献类型：
--
作者：
Kim NY;Bai SJ;Kim HI;Hong JH;Nam HJ;Koh JC;Kim HJ
据报道，气腹和仰卧位会刺激交感神经系统，可能会增加心律失常的风险。我们评估了机器人胃切除术中长时间仰卧位气腹对心率校正QT(QTC)间期的影响。这项前瞻性观察研究涉及28名接受机器人胃切除术的患者。分别于麻醉诱导前(基线)、气管插管后10min、气腹诱导后1、5、30、60、90min、仰卧位气腹脱气后、手术结束时记录QT间期值。主要结果是QTC间期，在气腹结合仰卧位后90分钟测量。与术前相比，气腹后1分钟和60分钟QT间期显著延长，90分钟达到高峰，并持续至手术结束。然而，没有出现明显的血流动力学变化。在机器人胃切除术中，在仰卧位长期应用二氧化碳气腹可显著延长QTC间期。因此，对于易发展为室性心律失常的患者，需要勤奋的护理和密切的监测。试验注册：在ClinicalTrials.gov注册；https://clinicaltrials.gov/ct2/show/NCT02604979；注册号NCT02604979
Pneumoperitoneum and the head-up position reportedly stimulate the sympathetic nervous system, potentially increasing the risk of cardiac arrhythmia. We evaluated the effects of a long duration of pneumoperitoneum in the head-up position on the heart rate-corrected QT (QTc) interval during robotic gastrectomy. This prospective observational study involved 28 patients undergoing robotic gastrectomy. The QTc interval was recorded at the following time points: before anaesthetic induction (baseline); 10 minutes after tracheal intubation; 1, 5, 30, 60, and 90 minutes after pneumoperitoneum induction in the head-up position; after pneumoperitoneum desufflation in the supine position; and at the end of surgery. The primary outcome was the QTc interval, which was measured 90 minutes after pneumoperitoneum combined with the head-up position. Compared with baseline, the QTc interval was significantly prolonged at 1 and 60 minutes after pneumoperitoneum, peaked at 90 minutes, and was sustained and notably prolonged until the end of surgery. However, no considerable haemodynamic changes developed. A long period of carbon dioxide pneumoperitoneum application in a head-up position significantly prolonged the QTc interval during robotic gastrectomy. Therefore, diligent care and close monitoring are required for patients who are susceptible to developing ventricular arrhythmia. Trial Registration: Registered at ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT02604979; Registration number NCT02604979
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DOI：
10.1007/s10840-005-4592-4
发表时间：
2005-11-01
影响因子：
1.8
作者：
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DOI：
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DOI：
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2002-10-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
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