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Effect of desflurane at less than 1 MAC on QT interval prolongation induced by tracheal intubation

S H Kim1, S Y Park, W S Chae

  • 1Department of Anaesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Bucheon Hospital, 1174 Jung-Dong, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, Republic of Korea. aurellius@naver.com

British Journal of Anaesthesia
|December 17, 2009
PubMed
Abstract

Insights

Low-concentration desflurane (less than 1 minimum alveolar concentration) did not prolong the QT interval during tracheal intubation. This study found no significant difference in QTc prolongation between patients receiving desflurane and those receiving oxygen alone.

Area of Science:

  • Anesthesiology
  • Cardiology
  • Pharmacology

Background:

  • Desflurane at concentrations above 1 minimum alveolar concentration (MAC) is known to prolong the QT interval.
  • The effect of desflurane at sub-MAC concentrations on QT interval prolongation, particularly during tracheal intubation, remains unclear.

Purpose of the Study:

  • To investigate whether desflurane concentrations below 1 MAC influence the QT interval prolongation induced by tracheal intubation.

Main Methods:

  • A randomized controlled trial involving 44 subjects undergoing anesthesia induction with propofol.
  • Subjects received either 1 MAC desflurane in oxygen or oxygen alone prior to tracheal intubation.
  • QT intervals were corrected using Bazett's (QTcB) and Fridericia's (QTcF) formulae; secondary outcomes included Tp-e, mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS).

Main Results:

  • No significant difference in QTcB or QTcF was observed immediately after tracheal intubation between the desflurane and control groups.
  • Heart rate (HR) and the interval from peak to T wave end (Tp-e) did not differ between groups.
  • Mean arterial pressure (MAP) and bispectral index (BIS) scores were significantly lower in the desflurane group post-intubation.

Conclusions:

  • Administration of desflurane at 1 MAC during controlled ventilation does not exacerbate QT interval prolongation caused by tracheal intubation.
  • These findings suggest that desflurane at this concentration may be safely used in the context of tracheal intubation without adverse cardiac electrical effects.

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