The effect of propofol concentration on dispersion of myocardial repolarization in children

Anesthesia and Analgesia
Helen V Hume-SmithSimon D Whyte

Abstract

QT interval prolongation on the electrocardiogram (ECG) may be drug-induced and is traditionally associated with torsades des pointes. A better predictor of torsades des pointes is the time interval between the peak and the end of the T-wave (Tp-e). Older studies of propofol's effect on the corrected interval (QTc) are conflicting and confounded by polypharmacy. It was recently shown that target-controlled infusion of propofol at 3 microg/mL has no effect on QTc or Tp-e. This plasma concentration of propofol is at the extreme lower end of the range for surgical anesthesia. In this randomized, double-blind, clinical study, we investigated the dose-response relationship between propofol, QTc, and Tp-e in a range of doses clinically relevant for surgical anesthesia. Sixty healthy unpremedicated children, aged 3-10 yr, were recruited. Subjects were randomized to receive target-controlled infusions of propofol, to achieve 1 of 3 plasma concentrations: 3, 4.5, and 6 microg/mL. A preoperative 12 lead ECG was performed and repeated 5 min after induction. Two investigators, blinded to group allocation and to the timing of the ECG traces, independently measured QTc and Tp-e within and between each group. Paired t-tests were used to compa...Continue Reading

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Citations

Feb 5, 2011·Pediatric Emergency Care·Christine E MikesellBonnie R Rachman
Dec 7, 2013·British Journal of Anaesthesia·C StaikouE Stavroulakis
Sep 15, 2010·The Kaohsiung Journal of Medical Sciences·Volkan HanciIsil Ozkoçak Turan
May 4, 2013·Journal of Clinical Anesthesia·Emmanuel EdsonJohn G T Augoustides
Jul 7, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Lukasz J KrzychAndrzej Bochenek
Feb 13, 2014·American Journal of Therapeutics·Jalaj GargWilliam H Frishman
Nov 12, 2017·Journal of Anesthesia·Chao LiangZhanggang Xue
Sep 1, 2015·Journal of Dental Anesthesia and Pain Medicine·Kyung Jin KimTeo Jeon Shin
Oct 2, 2019·Journal of Clinical Pharmacy and Therapeutics·Mustafa Begenc TascanovKadir Demir
Dec 21, 2011·Anesthesia and Analgesia·Shubhayan Sanatani, Simon Whyte
Jul 31, 2014·Anesthesia and Analgesia·Simon D WhyteShubhayan Sanatani
Sep 27, 2012·Anesthesiology·Aruna T NathanVictoria L Vetter
Sep 5, 2017·Cancer Biomarkers : Section a of Disease Markers·Yu LiRuirong Tu
Jul 24, 2020·Scientific Reports·Christian EllermannGerrit Frommeyer
Jan 27, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Naoko NiimiKatherine Zaleski

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