Document Detail

Sustained prolongation of the QTc interval after anesthesia with sevoflurane in infants during the first 6 months of life.
MedLine Citation:
PMID:  12606907     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sevoflurane, an inhalational anesthetic frequently administered to infants, prolongs the QT interval of the electrocardiogram in adults. A long QT interval resulting in fatal arrhythmia may also be responsible for some cases of sudden death in infants. As the QT interval increases during the second month of life and returns to the values recorded at birth by the sixth month, we evaluated the effect of sevoflurane on the QT interval during and after anesthesia in this particular population. METHODS: In this prospective two-group trial we examined pre-, peri-, and postoperative electrocardiograms of 36 infants aged 1 to 6 months scheduled for elective inguinal or umbilical hernia repair. Anesthesia was induced and maintained with either sevoflurane, or the well-established pediatric anesthetic halothane. Heart rate corrected (c) QTc and JTc interval (indicator of intraventricular conduction delays) were recorded from electrocardiograms before and during anesthesia, and at 60 min after emergence from anesthesia. RESULTS: Prolonged QTc was observed during sevoflurane anesthesia (mean [+/-SD], 473 +/- 19 ms, P< 0.01). Sixty minutes after emergence from anesthesia, QTc was still prolonged (433 +/- 15 ms) in infants treated with sevoflurane compared with those treated with halothane (407 +/- 33 ms, P< 0.01). Analogous differences were found for the JTc interval. CONCLUSIONS: Despite a shorter elimination time than better known inhalational anesthetics, sevoflurane induction and anesthesia results in sustained prolongations of QTc and JTc interval in infants in the first 6 months of life. Electrocardiogram monitoring until the QTc interval has returned to preanesthetic values may increase safety after sevoflurane anesthesia.
Alex Loeckinger; Axel Kleinsasser; Stephan Maier; Bernhard Furtner; Christian Keller; Gabriele Kuehbacher; Karl H Lindner
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Publication Detail:
Type:  Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  98     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-27     Completed Date:  2003-03-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-42     Citation Subset:  AIM; IM    
Department of Anesthesiology and Critical Care Medicine, The Leopold-Franzens University, Innsbruck, Austria.
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MeSH Terms
Anesthetics, Inhalation / pharmacology*
Electrocardiography / drug effects*
Halothane / pharmacology
Infant, Newborn
Methyl Ethers / pharmacokinetics,  pharmacology*
Prospective Studies
Time Factors
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 151-67-7/Halothane; 28523-86-6/sevoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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