What question did this study set out to answer?

To evaluate and compare the effects of propofol, methohexital, and midazolam on corrected QT (QTc) interval, heart rate, and arterial pressure during anesthesia induction.

May 1, 1990Acta Anaesthesiologica Scandinavica

QT interval of the ECG, heart rate and arterial pressure using propofol, methohexital or midazolam for induction of anaesthesia

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Why the study?

Do propofol, methohexital, or midazolam differentially affect the QTc interval, heart rate, and arterial pressure during induction of anaesthesia in ASA class I-II patients?

Population

87 ASA class I-(II) patients undergoing induction of anaesthesia

Comparison

Propofol 2 mg/kg, methohexital 2 mg/kg, or… vs Active comparators

Design

RCT, Randomly allocated to one of the three anaesthetic groups

Follow-up

During induction of anaesthesia

Authors

LSL. SaarnivaaraUniversity of Helsinki UKU.‐M. KlemolaHelsinki University Hospital LLL. LindgrenTampere University

Discussion

Member takes

Implication

Baseline QTc should guide induction agent selection; RCT evidence supports tailored use to minimize arrhythmia risk.

Key Points

To evaluate and compare the effects of propofol, methohexital, and midazolam on corrected QT (QTc) interval, heart rate, and arterial pressure during anesthesia induction.
Randomized trial allocating 87 ASA class I–(II) patients to receive propofol (2 mg/kg), methohexital (2 mg/kg), or midazolam (0.3 mg/kg) for induction of anesthesia.
Measured QTc intervals, arterial pressure, and heart rate at baseline, post-induction, 30–60 seconds after suxamethonium injection, and following tracheal intubation, stratifying by baseline QTc status (>440 ms).
Baseline prolonged QTc intervals (>440 ms) occurred in 29% to 41% of patients across groups; among those with normal baseline intervals, all agents prolonged QTc, but values remained within the normal range only with propofol, whereas midazolam induced significant prolongation after suxamethonium and intubation.
In patients with baseline prolonged QTc, midazolam significantly shortened the interval, while propofol significantly reduced QTc 60 seconds after suxamethonium.
Heart rate increased significantly only following methohexital, while all groups displayed cardiovascular intubation responses; ECG changes occurred in 0% to 17% of patients and showed no correlation with QTc prolongation.

Structured PICO

Do propofol, methohexital, or midazolam differentially affect the QTc interval, heart rate, and arterial pressure during induction of anaesthesia in ASA class I-II patients?

Population

87 ASA class I-(II) patients undergoing induction of anaesthesia

Intervention

Propofol 2 mg/kg, methohexital 2 mg/kg, or midazolam 0.3 mg/kg for induction of anaesthesia

Comparator

Active comparators (the three drugs were compared against each other)

Outcome

QT interval of the ECG corrected by the heart rate (QTc), heart rate, and arterial pressuresurrogate

Propofol and methohexital are preferred over midazolam to avoid QTc prolongation in patients with normal baseline QTc, whereas midazolam is preferred in those with prolonged baseline QTc.

Cite This Study

Saarnivaara et al. (1990) studied this question.

synapsesocial.com/papers/6a884798580ea41f01583d4d https://doi.org/10.1111/j.1399-6576.1990.tb03085.x

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QT interval of the ECG, heart rate and arterial pressure using propofol, methohexital or midazolam for induction of anaesthesia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

QT interval of the ECG, heart rate and arterial pressure using propofol, methohexital or midazolam for induction of anaesthesia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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