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Effect of dexmedetomidine on the QT interval in pediatric patients undergoing general anesthesia

Hiromi Kako1,2, Senthil G Krishna3,4, Roby Sebastian3,4

  • 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Hiromi.Kako@Nationwidechildrens.org.

Journal of Anesthesia
|August 5, 2015
PubMed

Insights

Dexmedetomidine administration significantly shortened the QTc interval in pediatric patients receiving sevoflurane anesthesia, contrasting with a QTc lengthening observed in the control group. This indicates dexmedetomidine may mitigate sevoflurane-induced QTc changes.

Area of Science:

  • Anesthesiology
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Dexmedetomidine use is increasing in pediatric surgery.
  • Limited data exist on its QT interval effects in children.
  • Sevoflurane anesthesia can affect cardiac repolarization.

Purpose of the Study:

  • To evaluate the effect of dexmedetomidine on the QT interval in pediatric patients undergoing sevoflurane anesthesia.
  • To compare QT interval changes between dexmedetomidine and control groups.

Main Methods:

  • Prospective case-control study with 50 pediatric patients.
  • Three ECGs obtained: baseline, post-sevoflurane, and post-dexmedetomidine (or equivalent time in controls).
  • Analysis of variance used to compare QTc intervals between groups and time points.

Main Results:

  • The QTc interval progressively increased with sevoflurane in the control group (P = 0.006).
  • Dexmedetomidine administration resulted in a significant QTc shortening compared to post-induction values (436 ± 25 ms vs. 418 ± 17 ms; P < 0.01).
  • No demographic differences between the 25-patient dexmedetomidine and 25-patient control groups.

Conclusions:

  • Sevoflurane anesthesia alone was associated with QTc interval lengthening in pediatric patients.
  • Dexmedetomidine significantly shortened the QTc interval compared to post-induction and control groups.
  • Dexmedetomidine may have a protective effect against sevoflurane-induced QTc prolongation in children.
Abstract

Keywords:
DexmedetomidineElectrocardiographyPediatricsQT intervalSevoflurane

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