A Comparison of the Effect of Sevoflurane and Propofol on Ventricular Repolarisation after Preoperative Cefuroxime Infusion.

Yanqiu Liu,Xiaokui Fu,Zijun Wang,Guilong Wang,Hong Gao,Li An,Jing Yi,Chunlei Wen

doi:10.1155/2019/8978906

Yanqiu Liu, Xiaokui Fu + Show 6 more

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https://doi.org/10.1155/2019/8978906

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Abstract

The aim of this study is to investigate the changes in QT, QTc, and Tp-e intervals and Tp-e/QT ratio on surface electrocardiogram (ECG) signals during anaesthesia induction using propofol or sevoflurane after preoperative cefuroxime infusion. Some 120 cases of gynaecological patients are randomly divided into propofol (P) and sevoflurane (S) groups (n=60). After cefuroxime (1.5 g) was infused in the two groups of patients, propofol target controlled infusion (TCI) was conducted in the P group for 5 min to realise a plasma concentration of 4 μg/ml while patients in the S group inhaled anaesthesia by infusing 1.3 MAC sevoflurane for 6 min. The 12-lead ECGs were separately collected before infusing cefuroxime (T1), after infusing cefuroxime (T2), and after infusing propofol or sevoflurane (T3) to measure QT and Tp-e intervals, calculate QTc and Tp-e/QT, and record MAP and HR. Finally, we demonstrated that QT, QTc, and Tp-e intervals and Tp-e/QT ratio had no change (P > 0.05) after cefuroxime infusion in the two groups of patients compared with that before infusing antibiotics. Moreover, after conducting preoperative cefuroxime infusion, using propofol and sevoflurane had no influence on Tp-e interval, but sevoflurane can significantly prolong QT and QTc intervals (P < 0.05).

Highlights

Antibiotics are the favourite drugs used to prevent and cure infectious diseases; the cardiotoxicity caused by antibiotics cannot be ignored with the extending application in clinical practice [1,2,3]
Propofol probably shortens, prolongs, or does not change the QTc interval [10,11,12, 14] while sevoflurane prolongs the QT interval [14]. Antibiotics and anaesthetics both have effects on QT interval. It has not been clarified whether using propofol or sevoflurane, after antibiotic infusion, will aggravate abnormal ventricular repolarisation and increase transmural dispersion of repolarisation (TDR) so as to increase perioperative arrhythmia
The study evaluated the safety of patients after being anaesthetised using propofol or sevoflurane in view of cardiac electrophysiology, which provides references for future clinical anaesthesia

Summary

Introduction

Antibiotics are the favourite drugs used to prevent and cure infectious diseases; the cardiotoxicity caused by antibiotics cannot be ignored with the extending application in clinical practice [1,2,3]. Propofol (intravenous anaesthetic) probably shortens, prolongs, or does not change the QTc interval [10,11,12, 14] while sevoflurane (inhalation anaesthetic) prolongs the QT interval [14] Antibiotics and anaesthetics both have effects on QT interval. It has not been clarified whether using propofol or sevoflurane, after antibiotic infusion, will aggravate abnormal ventricular repolarisation and increase TDR so as to increase perioperative arrhythmia. The study investigated the changes of QT, QTc, and Tp-e intervals and the ratio of Tp-e/QT in ECG during anaesthesia induction by using propofol or sevoflurane after infusing cefuroxime. The study evaluated the safety of patients after being anaesthetised using propofol or sevoflurane in view of cardiac electrophysiology, which provides references for future clinical anaesthesia

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