Wpływ desfluranu na odstęp QT i skorygowany odstęp QTc u chorych poddawanych chemioterapii antracyklinami

*Radosław Owczuk¹, Magdalena A. Wujtewicz¹, Wioletta Sawicka¹, Aleksandra Suszyńska-Mosiewicz¹, Agnieszka Polak¹, Jarosław Skokowski², Maria Wujtewicz¹

Summary
Background.Desflurane, like other newer halogenated agents, may significantly prolong the QT interval. Anthracycline therapy reduces repolarisation reserve and markedly prolongs the QT interval. Thus, anaesthesia with desflurane in patients undergoing chemotherapy may contribute to the development of life threatening proarrhythmia.
Methods. Forty women, scheduled for breast cancer surgery, were divided into two groups. Group A consisted of twenty women previously treated with anthracyclines, and group B consisted of twenty women who did not receive chemotherapy. Patients were premedicated with oral midazolam and induced with etomidate, vecuronium, and fentanyl. Anaesthesia was maintained with N₂O:O₂ (2:1) and 2.5-3 vol% desflurane. QT intervals, corrected QT intervals, heart rate, and arterial blood pressures were noted before anaesthesia, after tracheal intubation, at 3, 5, 15 and 30 min of desflurane anaesthesia, and during recovery.
Results. Prolongation of the QT interval, but not the corrected QT interval, was detected in both groups. The number of patients in group A, who had a QT interval prolonged over 450 msec at 3 and 5 minutes of anaesthesia, was significantly higher than in group B.
Conclusion. Patients receiving anthracyclines for breast cancer are at a higher risk of torsadogenic QT interval prolongation.

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