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Minerva anestesiologica · Sep 2016
Randomized Controlled TrialA comparison of QTc intervals after laryngoscopic intubation and i-gel insertion during propofol-sevoflurane anaesthesia.
- Hyo J Byon, Jeongyun Song, Helen K Shinn, Hyunkeun Lim, Choonsoo Lee, and Hyunkyoung Lim.
- Department of Anesthesiology and Pain Medicine, Institute of Anesthesia and Pain Research, Yonsei University College of Medicine, Seoul, South Korea - kiboy0929@gmail.com.
- Minerva Anestesiol. 2016 Sep 1; 82 (9): 950-6.
BackgroundLaryngoscopic intubation and supraglottic airway device insertion can prolong the corrected QT (QTc) interval during anaesthetic induction even in healthy patients. No prior study has compared the effect of laryngoscopic intubation and supraglottic airway device, i-gel, insertion on the QTc interval change.MethodsPatients were randomised to either the intubation group (N.=25) or the i-gel group (N.=25) before induction. The QT interval was sequentially measured in lead II following a standard anaesthetic technique for induction using propofol and sevoflurane. Four sequential QT values were applied to the Bazett's formula to correct for the effect of heart rate on the QT interval, and then averaged. The peak QTc interval, the duration of QTc prolongation >20 ms compared to the QTc value immediately before intubation or i-gel insertion and the incidence of the QTc intervals >500 ms were measured.ResultsThe peak QTc interval was lower in i-gel group (458.4±24.3 ms) than in intubation group (488.6±32.6 ms) (P=0.001). The duration of QTc prolongation >20 ms compared to the QTc values at immediately before intubation or i-gel insertion was significantly longer in the intubation group (136.5±104.5 s) than that of the i-gel group (56.9±56.5 s) (P=0.031). The number of patients with QTc interval >500 ms was significantly lower in the i-gel group (4%) than in the intubation group (48%).ConclusionsThe insertion of the i-gel produces less QTc interval change than laryngoscopic intubation. The i-gel may be advantageous to patients who are at risk of QTc prolongation, high blood pressure and tachycardia.
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