Key result
Severe pre-eclampsia was associated with a longer baseline QT interval (453.10 vs 399 ms, P<0.001), which was significantly shortened and normalized by spinal anesthesia.
Why the study?
The study aimed to compare the effect of spinal anesthesia on QT interval between severe pre-eclamptic and normotensive parturients undergoing cesarean section.
Does spinal anesthesia using 0.5% hyperbaric bupivacaine improve prolonged QT interval in severe pre-eclamptic parturients undergoing cesarean section?
Observational (n=100)
No
Does spinal anesthesia using 0.5% hyperbaric bupivacaine improve prolonged QT interval in severe pre-eclamptic parturients undergoing cesarean section?
Absolute Event Rate: 453.1% vs 399%
p-value: p=<0.001
Spinal anesthesia with 0.5% hyperbaric bupivacaine normalizes the prolonged QT interval commonly seen in severe pre-eclamptic parturients undergoing cesarean section.
Spinal anesthesia QT effects in severe pre-eclampsia remain uncertain; leaves open whether monitoring alters arrhythmia risk during cesarean delivery.
Aim: This study aimed to compare the effect of spinal anesthesia on QT interval in severe pre-eclamptic and normotensive parturients who underwent cesarean section in a Nigerian tertiary hospital. Patients and Methods: Twelve-lead electrocardiogram (ECG) was obtained before, and at intervals after spinal anaesthesia on fifty severe pre-eclamptic (Group A) and fifty normotensive parturients (Group B) who underwent caesarean section. The effect of spinal anaesthesia on QT interval was compared. Results: The preoperative (baseline) mean QT interval was longer in group A than in group B; 453.10 ± 34.11 ms versus 399 ± 18.79 ms, P < 0.001. The prevalence of prolonged QT interval in the severe pre-eclamptic group before spinal anesthesia was 80% while in the normotensive group it was 0%, P < 0.001. At 5, 30, 60, and 120 min after the establishment of spinal anesthesia, the mean QT interval in the severe pre-eclamptic group was shortened and maintained within normal limits; 414.74 ± 28.05, 418.28 ± 30.95, 411.18 ± 19.21 and 401.36 ± 17.52 ms with P < 0.001 throughout. In the normotensive group, there was no significant change in the mean QT interval. Conclusions: This study demonstrated that the QT interval was more prolonged among the severe pre-eclamptic parturients. Spinal anesthesia using 0.5% hyperbaric bupivacaine normalized the QT interval and maintained it within normal limits during the study period.
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Adedapo et al. (2022) conducted an observational in Severe pre-eclampsia (n=100). Severe pre-eclampsia vs. Normotensive parturients was evaluated on Preoperative mean QT interval (ms) (p=<0.001). Severe pre-eclampsia was associated with a longer baseline QT interval (453.10 vs 399 ms, P<0.001), which was significantly shortened and normalized by spinal anesthesia.
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