Effect of different general anaesthetics on ventricular repolarisation in robot-assisted laparoscopic prostatectomy

Jin Ha Park, Ki Young Lee, Young Deuk Choi, Jongsoo Lee, Hye Jung Shin, Dong Woo Han, Jiwon Baek, So Yeon Kim

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Ventricular repolarisation is affected differently by the types of anaesthetics used. This study aimed to compare the effect of different types of anaesthetics on ventricular repolarisation during robot-assisted laparoscopic radical prostatectomy (RALP). Methods: Sixty-nine patients were randomly assigned in a 1:1:1 ratio to the Sevoflurane (sevoflurane/remifentanil), Desflurane (desflurane/remifentanil) or total intravenous anaesthesia (TIVA [propofol/remifentanil]) groups; however, only 67 patients completed the study. The primary outcome was heart rate-corrected QT (QTc) interval collected at nine time points during RALP. Bazett’s (QTcB) and Fridericia’s (QTcF) formulae were used for QT interval correction. The secondary outcomes were Tpeak-Tend (Tp-e) interval and Tp-e/QT ratio that were collected at the same time points. Results: The QTcB and QTcF intervals were significantly prolonged during surgery in all groups; however, these values showed significant intergroup differences with time. After assuming the Trendelenburg position, the QTcB and QTcF intervals were significantly longer in the Desflurane group than in the other two groups, and this prolongation continued until the end of surgery. Intra-operatively, the QTcB and QTcF intervals exceeded 450 ms in six and five patients, respectively, in the Desflurane group, but in none in the TIVA group. Moreover, the incidence of intra-operative QTc interval prolongation >20 ms and >60 ms was significantly higher in the Desflurane group than in the TIVA group. There were no significant differences in Tp-e intervals and Tp-e/QT ratio among the three groups during surgery. Conclusions: To minimise QTc interval prolongation during RALP, TIVA with propofol/remifentanil is recommended for general anaesthesia.

Original languageEnglish
Pages (from-to)1243-1252
Number of pages10
JournalActa Anaesthesiologica Scandinavica
Volume64
Issue number9
DOIs
Publication statusPublished - 2020 Oct 1

Bibliographical note

Publisher Copyright:
© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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