Evaluation of QT interval of patients using muscle relaxants under general anesthesia, randomized clinical trial

Abstract

Objective: The aim of the study was to investigate the effects of rocuronium, mivacurium, and atracurium on arrhythmia markers, QT interval, and QT dispersion (QTd). Method: Ninety patients scheduled for septorhinoplasty were randomly assigned to one of three groups of 30. During the induction of anesthesia, muscle relaxants of 0.6 mg/kg rocuronium in Group R, 0.2 mg/kg mivacurium in Group M, and 0.5 mg/kg atracurium in Group A were employed. Mean blood pressure (MAP), heart rate (HR), and electrocardiogram (ECG) values were measured before induction of anesthesia (T0), immediately after induction of anesthesia (T1), at 1 minute (T2), 5 minutes (T3), 10 minutes (T4) and 15 minutes (T5) after muscle relaxant administration, and QT, corrected QT (QTc), QTd and corrected QTd (QTcd) intervals were recorded. Results: When the groups were compared in terms of QTcd values, the difference between mivacurium and atracurium was significant in terms of T5 values, and atracurium (T5) QTcd was found to be shorter (p<0.05). Group M had 5 of the 6 measures with pathological QTc prolongation. Conclusions: Because the prevalence of pathological QTc is greater in mivacurium, further clinical trials should be conducted to challenge the use of mivacurium in individuals with a long QT interval.