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Comparison of the effect of sevoflurane and desflurane on postoperative arrhythmia and QT dispersion

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Gozdemir M. , Yeter E. , Akcay M. , Kurdoglu E. , Gumus T. , Keleş T. , Bilen E. , Kanbak O.

Open Medicine

2010

tom 5

nr 2

209-214

The aim of this study was to investigate the effect of sevoflurane and desflurane on cardiac arrhythmias in adult patients who will be anesthetized. A total of 40 patients who were in the ASA I–II group and who were to undergo elective surgery were included in the study. No pre-medication was administered to the patients. They were monitored with the Holter equipment at preoperative 24 hours, and also at postoperative 24 hours on condition that Holter monitoring will begin before induction. Following routine monitoring, the patients were randomly divided into two equal groups; group one was given sevoflurane and group two was given desflurane. In this study, desflurane and sevoflurane resulted in both a significant prolongation of QT and QTc and a significant increase in QT and QTc dispersion when compared with the basal values. In the sevoflurane group, there was no significant increase in postoperative ventricular arrhythmia, compared to that during the preoperative period. However, this increase was significant in the desflurane group (p = 0.009). Sevoflurane and desflurane result in an increase in QT dispersion. Postoperative rhythmic control should carefully be monitored, especially in the desflurane group.

Perioperative challenges in a primary hyperparathyroid patient with osteitis fibrosa cystic and borderline QTc: a case-based review and practice analysis

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HMR., Karim , PK., Neema , Iqbal J.

Progress in Health Sciences

2019

tom 2

57-63

Introduction: Perioperative care of primary hyperparathyroidism patients is a significant challenge. The challenge increases when the preoperative optimization of the patient is suboptimal due to any reason. Concomitant complications like osteitis fibrosa cystic, renal involvement, and multiple electrolyte abnormalities predispose these patients towards multiple morbidities and even mortality during the perioperative period. It is known that the hypercalcemia causes shortened QT, and the inhalational and intravenous anesthesia drug-induced QT prolongation is likely to be buffered. On the other hand, prolonged QTc in primary hyperparathyroid patients in the presence of hypercalcemia is more uncommon, but an extremely challenging situation for anesthesiologists as these patients are more prone to torsadogenesity. Materials and methods: A case-based review is presented in this paper. To review the current practice and opinions, we searched PubMed and Google Scholar using the advanced search engine with the combination index words of primary hyper-parathyroidism, anesthesia, anaesthesia, anesthesia management, and anaesthesia management with a time frame of January 1, 2000, to August 30, 2018. Results: The results are enumerated in the text. Although anesthetic management of primary hyperparathyroid patients is available in the literature, anesthetic management of primary hyperparathyroid patients with prolonged or borderline QTc is not well described. In this paper, we present a case that was successfully managed using Desflurane based minimal flow anesthesia, which is probably also the first of such. Conclusion: Balanced anesthesia with Propofol induction and modern inhalational agents for maintenance and non-depolarizing neuromuscular blockade appears to be safe method of anesthesia.