Key result
Sevoflurane significantly prolonged QT and QTc intervals compared to propofol during anaesthesia induction after preoperative cefuroxime infusion (P < 0.05).
Why the study?
The study sought to investigate ECG repolarisation markers (QT, QTc, Tp-e intervals, and Tp-e/QT ratio) during anaesthesia induction with propofol versus sevoflurane after preoperative cefuroxime infusion.
Does sevoflurane compared to propofol affect ventricular repolarisation after preoperative cefuroxime infusion in gynaecological patients?
RCT (n=120)
Randomly divided
Does sevoflurane compared to propofol affect ventricular repolarisation after preoperative cefuroxime infusion in gynaecological patients?
Sevoflurane, but not propofol, prolongs QT and QTc intervals during anaesthesia induction following cefuroxime infusion, suggesting a differential effect on ventricular repolarisation.
Supports preferring propofol to minimize QT prolongation risk after cefuroxime; extends RCT evidence on differential anesthetic effects on repolarization.
The aim of this study is to investigate the changes in QT, QTc, and Tp-e intervals and Tp-e/QT ratio on surface electrocardiogram (ECG) signals during anaesthesia induction using propofol or sevoflurane after preoperative cefuroxime infusion. Some 120 cases of gynaecological patients are randomly divided into propofol (P) and sevoflurane (S) groups (n=60). After cefuroxime (1.5 g) was infused in the two groups of patients, propofol target controlled infusion (TCI) was conducted in the P group for 5 min to realise a plasma concentration of 4 μg/ml while patients in the S group inhaled anaesthesia by infusing 1.3 MAC sevoflurane for 6 min. The 12-lead ECGs were separately collected before infusing cefuroxime (T1), after infusing cefuroxime (T2), and after infusing propofol or sevoflurane (T3) to measure QT and Tp-e intervals, calculate QTc and Tp-e/QT, and record MAP and HR. Finally, we demonstrated that QT, QTc, and Tp-e intervals and Tp-e/QT ratio had no change (P > 0.05) after cefuroxime infusion in the two groups of patients compared with that before infusing antibiotics. Moreover, after conducting preoperative cefuroxime infusion, using propofol and sevoflurane had no influence on Tp-e interval, but sevoflurane can significantly prolong QT and QTc intervals (P < 0.05).
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Liu et al. (2019) conducted an RCT in Gynaecological patients undergoing anaesthesia (n=120). Sevoflurane vs. Propofol (TCI 4 μg/ml for 5 min) was evaluated on Changes in QT, QTc, and Tp-e intervals and Tp-e/QT ratio (p=< 0.05). Sevoflurane significantly prolonged QT and QTc intervals compared to propofol during anaesthesia induction after preoperative cefuroxime infusion (P < 0.05).
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