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Clin. Exp. Pharmacol. Physiol. · Sep 2008
Comparative Study Clinical TrialEffect of anaesthetic agents on p-wave dispersion on the electrocardiogram: comparison of propofol and desflurane.
- Radoslaw Owczuk, Magdalena A Wujtewicz, Wioletta Sawicka, Agnieszka Polak-Krzeminska, Aleksandra Suszynska-Mosiewicz, Krystyna Raczynska, and Maria Wujtewicz.
- Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Poland. r.owczuk@amg.gda.pl
- Clin. Exp. Pharmacol. Physiol. 2008 Sep 1;35(9):1071-6.
AbstractAnaesthetics influence cardiac electrical activity by various mechanisms; thus, they may have pro-arrhythmic or anti-arrhythmic actions. Increased P-wave dispersion is associated with a risk of paroxysmal atrial fibrillation. The aim of the present study was to analyse the impact of propofol and desflurane on changes in P wave dispersion, which may reflect the anti-arrhythmic effects of these drugs. Fifty patients undergoing scheduled surgery were included in the study. Patients were divided into two equal groups: a propofol group and a desflurane group. Patients in the propofol group were initially administered 2.5 mg/kg propofol, followed by infusion of 6 mg/kg per h propofol. Anaesthesia in the desflurane group was achieved using inhalation induction, with concentrations up to 8-12.5 vol%. When signs of adequate anaesthesia were observed, the concentration of desflurane was reduced to 6 vol%. An electrocardiogram (ECG) was obtained before induction and then again 1, 3 and 5 min after the initiation of propofol infusion or the induction of anaesthesia in the desflurane group; additional measurements were performed after tracheal intubation. P-wave dispersion was assessed by differences in maximal and minimal P-wave duration on a 12-lead ECG. P-wave dispersion did not change over time in the desflurane group. In the propofol group, there was a significant decrease in P-wave dispersion after 3 and 5 min of anaesthesia. Significant differences were observed between study groups after 1, 3 and 5 min of anaesthesia, and disappeared after tracheal intubation. Mean and maximal P-wave duration did not change in either group. In conclusion, propofol decreases P-wave dispersion and this seems to be connected with the anti-arrhythmic properties of the drug.
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