Key result
Spinal anesthesia with 15 mg of hyperbaric bupivacaine significantly lengthened the QTc interval at 30 minutes compared to 10 mg (p=0.001), without causing severe arrhythmia.
Why the study?
Does a higher dose (15 mg) of spinal bupivacaine lengthen the QTc interval compared to a lower dose (10 mg) in patients undergoing inguinal hernia operations?
RCT (n=60)
Does a higher dose (15 mg) of spinal bupivacaine lengthen the QTc interval compared to a lower dose (10 mg) in patients undergoing inguinal hernia operations?
p-value: p=0.001
Higher doses of spinal bupivacaine lengthen the QTc interval in a dose-dependent manner, though without causing severe arrhythmias.
Suggests higher bupivacaine doses may transiently prolong repolarization without immediate clinical harm.
BACKGROUND Cardiac arrhythmia is a significant cause of morbidity and mortality. In this study, through examination of the effects on the QTc interval of different doses of hyperbaric bupivacaine, we investigated the relationship with arrhythmia. MATERIAL AND METHODS A total of 60 patients were separated into 2 groups: spinal block was applied with 10 mg bupivacaine to Group S1 and with 15 mg to Group S2. The mean arterial pressure (MAP) and heart rate (HR) values were recorded before the spinal block and at 5 and 30 min after the block and at 60 min postoperatively. By recording the time of the spinal sensory block to reach T10 dermatome (Anaesth T) and the duration of the surgical procedure (Surg T.), the QTc intervals were calculated. RESULTS The demographic data were similar in both groups. A statistically significant difference was determined between the S1 and S2 groups between the baseline and the 30 mins after spinal block QTc intervals (p=0.001). No statistically significant difference in HR values was determined between the groups at baseline, 5 min after spinal block, and 1 h after surgery (all p>0.05), but at 30 min after spinal block value there was a statistically significant difference (p=0.010). No statistically significant difference was determined in MAP values between the groups at baseline and 1 h after surgery (p>0.05). CONCLUSIONS The QTc interval lengthened in a dose-dependent manner after spinal anesthesia was applied with different doses of bupivacaine, but the doses used did not cause any severe arrhythmia.
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Hanbeyoğlu et al. (2017) conducted an RCT in Inguinal hernia (n=60). Hyperbaric bupivacaine vs. 10 mg was evaluated on QTc interval change from baseline to 30 mins after spinal block (p=0.001). Spinal anesthesia with 15 mg of hyperbaric bupivacaine significantly lengthened the QTc interval at 30 minutes compared to 10 mg (p=0.001), without causing severe arrhythmia.
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