Effects of remifentanil, nitroglycerin, and sevoflurane on the corrected QT and Tp-e intervals during controlled hypotensive anesthesia

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dc.contributor.authorCimen, Nuran Kavun
dc.contributor.authorKosem, Bahadir
dc.contributor.authorCimen, Tolga
dc.contributor.authorKartal, Seyfi
dc.contributor.authorMuslu, Bunyamin
dc.contributor.authorKarabayirli, Safinaz
dc.contributor.authorGozdemir, Muhammet
dc.date.accessioned2025-10-24T18:09:04Z
dc.date.available2025-10-24T18:09:04Z
dc.date.issued2016
dc.departmentMalatya Turgut Özal Üniversitesi
dc.description.abstractStudy objective: Controlled hypotension is a preferred method in various surgical operations, but limited data are available for the effects of drug combinations that are used to ensure the desired level of hypotension on cardiac repolarization. Design: Randomized, prospective, double-blinded study. Patients: The study comprised 65 patients undergoing septorhinoplasty surgery under general anesthesia. Interventions: Group S received sevoflurane inhalation alone, group R received sevoflurane and remifentant and group N received sevoflurane and nitroglycerine in a way that a mean arterial pressure of 60 +/- 5 mm Hg was achieved. Measurements: Electrocardiogram was performed before induction (T1), 30 minutes after induction (T2), and 5 minutes after extubation (T3). Corrected QT (QTc), QT dispersion (QTd), and corrected Tp-e (Tp-ec) intervals and Tp-e/corrected QT (Tp-e/QTc) ratio were calculated. Main results: QTc prolongation was observed at T2 and T3 in all groups, but only QTc prolongation at T2 was statistically significant in group S (P> .05). Significant prolongation of QTd interval at T2 and T3 was observed in group S (P< .05). In all groups, Tp-ec decreased at T2. However Tp-ec decrease was not statistically significant in group S (P= .103) and group R (P= .058). Tp-e/QTc was significantly decreased on T2 in all 3 groups, and it was returned to baseline at T3 (P< .05). Conclusion: The present study demonstrated that none of the 3 hypotensive anesthesia methods has an overall negative effect on Tp-e and Tp-e/QTc. Therefore, we conclude that all 3 methods can be used safely in terms of proarrhythmic risk, but increased sevoflurane consumption may require more attention due to significant prolongation of QTc and QTd. (C) 2016 Elsevier Inc. All rights reserved.
dc.identifier.doi10.1016/j.jclinane.2016.04.048
dc.identifier.endpage372
dc.identifier.issn0952-8180
dc.identifier.issn1873-4529
dc.identifier.pmid27555194
dc.identifier.scopus2-s2.0-84974593683
dc.identifier.scopusqualityQ1
dc.identifier.startpage365
dc.identifier.urihttps://doi.org/10.1016/j.jclinane.2016.04.048
dc.identifier.urihttps://hdl.handle.net/20.500.12899/3454
dc.identifier.volume33
dc.identifier.wosWOS:000382421800071
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Science Inc
dc.relation.ispartofJournal Of Clinical Anesthesia
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_20251023
dc.subjectControlled hypotension; Nitroglycerin; Remifentanil; Repolarization; Sevoflurane; Tp-e interval
dc.titleEffects of remifentanil, nitroglycerin, and sevoflurane on the corrected QT and Tp-e intervals during controlled hypotensive anesthesia
dc.typeArticle

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