Effects of conventional vs high-dose rocuronium on the QTc interval during anesthesia induction and intubation in patients undergoing coronary artery surgery: A randomized, double-blind, parallel trial
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Date
2015
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Abstract
Myocardial ischemia, as well as the induction agents used in anesthesia, may cause corrected QT interval (QTc) prolongation. The objective of this randomized, double-blind trial was to determine the effects of high- vs conventional-dose bolus rocuronium on QTc duration and the incidence of dysrhythmias following anesthesia induction and intubation. Fifty patients about to undergo coronary artery surgery were randomly allocated to receive conventional-dose (0.6 mg/kg, group C, n=25) or high-dose (1.2 mg/kg, group H, n=25) rocuronium after induction with etomidate and fentanyl. QTc, heart rate, and mean arterial pressure were recorded before induction (T0), after induction (T1), after rocuronium (just before laryngoscopy; T2), 2 min after intubation (T3), and 5 min after intubation (T4). The occurrence of dysrhythmias was recorded. In both groups, QTc was significantly longer at T3 than at baseline [475 vs 429 ms in group C (P=0.001), and 459 vs 434 ms in group H (P=0.005)]. The incidence of dysrhythmias in group C (28%) and in group H (24%) was similar. The QTc after high-dose rocuronium was not significantly longer than after conventional-dose rocuronium in patients about to undergo coronary artery surgery who were induced with etomidate and fentanyl. In both groups, compared with baseline, QTc was most prolonged at 2 min after intubation, suggesting that QTc prolongation may be due to the nociceptive stimulus of intubation. © 2015, Associacao Brasileira de Divulgacao Cientifica. All rights reserved.
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Aged , Androstanols , Anesthesia, General , Anesthetics, Intravenous , Arrhythmias, Cardiac , Arterial Pressure , Coronary Vessels , Double-Blind Method , Electrocardiography , Etomidate , Female , Fentanyl , Heart Rate , Humans , Intubation , Laryngoscopy , Male , Middle Aged , Neuromuscular Nondepolarizing Agents , Statistics, Nonparametric , etomidate , fentanyl , rocuronium , androstane derivative , etomidate , fentanyl , intravenous anesthetic agent , neuromuscular blocking agent , rocuronium , adult , anesthesia induction , Article , clinical assessment , clinical trial , controlled study , coronary artery surgery , double blind procedure , drug megadose , electrocardiography , female , heart arrhythmia , heart muscle ischemia , heart rate , human , intubation , major clinical study , male , mean arterial pressure , middle aged , outcome assessment , patient monitoring , QT prolongation , randomized controlled trial , adverse effects , aged , Arrhythmias, Cardiac , arterial pressure , coronary blood vessel , drug effects , general anesthesia , intubation , laryngoscopy , nonparametric test , procedures , surgery