Key result
Corrected QT and Tpeak-Tend intervals increased significantly after oxytocin injection during caesarean section, while the choice of vasopressor (ephedrine vs phenylephrine) had no effect.
Why the study?
Does oxytocin injection or the choice of vasopressor modify QTc and Tpeak-Tend intervals during caesarean section under spinal anaesthesia?
RCT (n=40)
Randomly assigned
Does oxytocin injection or the choice of vasopressor modify QTc and Tpeak-Tend intervals during caesarean section under spinal anaesthesia?
Oxytocin bolus during caesarean delivery significantly prolongs ventricular repolarization parameters (QTc and Tpeak-Tend), suggesting caution is needed in women with long QT syndrome.
Caution with oxytocin bolus in long-QT patients during caesarean; confirms vasopressor choice irrelevant for repolarization.
There are no guidelines for the anaesthetic management of caesarean section in women with long QT syndrome; the description of myocardial ventricular repolarisation in healthy women during caesarean delivery could be a first step. The aim of this study was to describe modification of the QT interval, corrected for heart rate, and the interval between the peak and the end of the T-wave (Tpeak-Tend interval) during caesarean section under spinal anaesthesia. We studied 40 patients scheduled for caesarean section under spinal anaesthesia. Patients were randomly assigned to receive either ephedrine or phenylephrine to prevent hypotension. We injected 5 IU oxytocin after delivery. Corrected QT and Tpeak-Tend intervals were unchanged from pre-operative values after induction of spinal anaesthesia, but increased significantly after oxytocin injection. The choice of vasopressor did not affect the Tpeak-Tend interval. The risk-benefit balance of oxytocin bolus during caesarean delivery should be discussed with women with a history of long QT syndrome.
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Guillon et al. (2010) conducted an RCT in Caesarean section under spinal anaesthesia (n=40). Ephedrine vs. Phenylephrine was evaluated on Modification of the QT interval, corrected for heart rate, and the Tpeak-Tend interval. Corrected QT and Tpeak-Tend intervals increased significantly after oxytocin injection during caesarean section, while the choice of vasopressor (ephedrine vs phenylephrine) had no effect.
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