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Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study

BACKGROUND: Children with sensorineural hearing loss are at risk of cardiac electrophysiologic abnormalities. Inhalational Sevoflurane induction in these children can cause QT prolongation. OBJECTIVES: In order to evaluate the safety of inhalational induction of anesthesia with sevoflurane in childr...

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Autores principales: Safaeian, Reza, Hassani, Valiollah, Mohseni, Masood, Ahmadi, Aslan, Ashraf, Haleh, Movaseghi, Gholamreza, Alimian, Mahzad, Mohebi, Elham, Koleini, Zahra Sadat, Pourkand, Shayesteh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885132/
https://www.ncbi.nlm.nih.gov/pubmed/31803586
http://dx.doi.org/10.5812/aapm.88805
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author Safaeian, Reza
Hassani, Valiollah
Mohseni, Masood
Ahmadi, Aslan
Ashraf, Haleh
Movaseghi, Gholamreza
Alimian, Mahzad
Mohebi, Elham
Koleini, Zahra Sadat
Pourkand, Shayesteh
author_facet Safaeian, Reza
Hassani, Valiollah
Mohseni, Masood
Ahmadi, Aslan
Ashraf, Haleh
Movaseghi, Gholamreza
Alimian, Mahzad
Mohebi, Elham
Koleini, Zahra Sadat
Pourkand, Shayesteh
author_sort Safaeian, Reza
collection PubMed
description BACKGROUND: Children with sensorineural hearing loss are at risk of cardiac electrophysiologic abnormalities. Inhalational Sevoflurane induction in these children can cause QT prolongation. OBJECTIVES: In order to evaluate the safety of inhalational induction of anesthesia with sevoflurane in children with sensorineural hearing loss, who are candidates for cochlear implant, its electrophysiologic effects was compared with intravenous induction of anesthesia with propofol. METHODS: In this double-blind randomized clinical trial, 61 children aged between one and eighteen years old, who were candidates for cochlear implantation, were randomly allocated to groups receiving anesthesia with sevoflurane (n = 32) or propofol (n = 29) for induction of anesthesia. Two 12-leads ECG were taken from all of patients before and after induction and QTc, Tp-e interval, and JTc were measured and compared. RESULTS: Two cases, who had pre-induction QTc longer than 500 ms were excluded from the study. Patients had similar age (102.58 ± 87 versus 101.46 ± 67 months, P = 0.95) and gender (males: 48.3% versus 56.3%, P = 0.53) distribution. The researchers observed significant post induction difference in QTc values between these groups (propofol 422.5 ± 40, sevoflurane 445.0 ± 29, P = 0.016). There was no significant difference in the percent QTc and Tp-e changes in propofol and sevoflurane groups. Greater percentage of patients with increased Tp-e interval (> 100 ms) in the sevoflurane group than the propofol group was also seen. There was no significant long QTc difference (QTc > 500 ms or more than 60 ms increase from baseline) after induction of anesthesia in the sevoflurane group compared to the propofol group (15.6% versus 13.8%, P = 0.84). CONCLUSIONS: After electrophysiological evaluations in children with sensorineural hearing loss, in patients whose pre-induction QTc is not longer than 500 ms, propofol seems safer than inhalational sevoflurane for induction of anesthesia.
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spelling pubmed-68851322019-12-04 Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study Safaeian, Reza Hassani, Valiollah Mohseni, Masood Ahmadi, Aslan Ashraf, Haleh Movaseghi, Gholamreza Alimian, Mahzad Mohebi, Elham Koleini, Zahra Sadat Pourkand, Shayesteh Anesth Pain Med Research Article BACKGROUND: Children with sensorineural hearing loss are at risk of cardiac electrophysiologic abnormalities. Inhalational Sevoflurane induction in these children can cause QT prolongation. OBJECTIVES: In order to evaluate the safety of inhalational induction of anesthesia with sevoflurane in children with sensorineural hearing loss, who are candidates for cochlear implant, its electrophysiologic effects was compared with intravenous induction of anesthesia with propofol. METHODS: In this double-blind randomized clinical trial, 61 children aged between one and eighteen years old, who were candidates for cochlear implantation, were randomly allocated to groups receiving anesthesia with sevoflurane (n = 32) or propofol (n = 29) for induction of anesthesia. Two 12-leads ECG were taken from all of patients before and after induction and QTc, Tp-e interval, and JTc were measured and compared. RESULTS: Two cases, who had pre-induction QTc longer than 500 ms were excluded from the study. Patients had similar age (102.58 ± 87 versus 101.46 ± 67 months, P = 0.95) and gender (males: 48.3% versus 56.3%, P = 0.53) distribution. The researchers observed significant post induction difference in QTc values between these groups (propofol 422.5 ± 40, sevoflurane 445.0 ± 29, P = 0.016). There was no significant difference in the percent QTc and Tp-e changes in propofol and sevoflurane groups. Greater percentage of patients with increased Tp-e interval (> 100 ms) in the sevoflurane group than the propofol group was also seen. There was no significant long QTc difference (QTc > 500 ms or more than 60 ms increase from baseline) after induction of anesthesia in the sevoflurane group compared to the propofol group (15.6% versus 13.8%, P = 0.84). CONCLUSIONS: After electrophysiological evaluations in children with sensorineural hearing loss, in patients whose pre-induction QTc is not longer than 500 ms, propofol seems safer than inhalational sevoflurane for induction of anesthesia. Kowsar 2019-08-05 /pmc/articles/PMC6885132/ /pubmed/31803586 http://dx.doi.org/10.5812/aapm.88805 Text en Copyright © 2019, Author(s) http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Research Article
Safaeian, Reza
Hassani, Valiollah
Mohseni, Masood
Ahmadi, Aslan
Ashraf, Haleh
Movaseghi, Gholamreza
Alimian, Mahzad
Mohebi, Elham
Koleini, Zahra Sadat
Pourkand, Shayesteh
Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title_full Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title_fullStr Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title_full_unstemmed Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title_short Comparison of the Effects of Propofol and Sevoflurane on QT Interval in Pediatrics Undergoing Cochlear Implantation: A Randomized Clinical Trial Study
title_sort comparison of the effects of propofol and sevoflurane on qt interval in pediatrics undergoing cochlear implantation: a randomized clinical trial study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885132/
https://www.ncbi.nlm.nih.gov/pubmed/31803586
http://dx.doi.org/10.5812/aapm.88805
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