Key result
Target concentration infusion of propofol significantly increased the QTc interval compared to baseline (p=0.003), with a further increase observed after tracheal intubation (p<0.0001).
Why the study?
Does target concentration infusion of propofol and tracheal intubation increase the QTc interval in unpremedicated ASA class I or II patients?
Does target concentration infusion of propofol and tracheal intubation increase the QTc interval in unpremedicated ASA class I or II patients?
p-value: p=0.003
Propofol infusion and tracheal intubation cause a statistically significant but clinically small increase in the QTc interval, suggesting caution is needed in patients with pre-existing prolonged QTc.
Propofol TCI-associated QTc prolongation may warrant caution in susceptible patients; leaves open arrhythmia risk and requires prospective confirmation.
This study was designed to evaluate the effect of target controlled infusion of propofol on QTc interval and tracheal intubation. Twenty-five unpremedicated, ASA class I or II patients were selected and target concentration infusion of propofol at 5 microg x ml(-1) was used throughout the study. The QTc interval was measured before anaesthetic induction (baseline, T1), 10 min after propofol infusion (T2), immediately after tracheal intubation (T3), and 1 min after tracheal intubation (T4). The QTc interval increased significantly at 10 min after the propofol infusion started compared to baseline (p = 0.003). After tracheal intubation, the QTc interval was further increased when compared to that at T2 (p < 0.0001). The increased QTc interval was within normal limit and no patient had an arrhythmia. In conclusion, although statistically significant, the increase in QTc interval was too small to be clinically significant during propofol infusion. However, the combination of propofol and tracheal intubation must be used carefully in patients with prolonged QTc interval.
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Kim et al. (2008) studied Patients requiring anesthesia (n=25). Target concentration infusion of propofol and tracheal intubation vs. Baseline (before anesthetic induction) was evaluated on QTc interval (p=0.003). Target concentration infusion of propofol significantly increased the QTc interval compared to baseline (p=0.003), with a further increase observed after tracheal intubation (p<0.0001).
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