The evaluation of Qtc interval, Qtc dispersion, dysrhythmia and heart rate variability undergoing sevoflurane and desflurane anesthesia in laporoscopic surgery

Abstract

Introduction: The aim of the present study was to asses the effects of sevoflurane and desflurane as inhalational anaesthetics on heart rate variability, dysrhythmias, QT interval and QT dispersion in patients who will undergo laporoscopic cholecystectomy under general anaesthesia. Material and Methods: 34 patients who will undergo elective laparoscopic cholecystectomy are enrolled in the study. The patients were monitored with Holter device 15 minutes before the anaesthesia induction till 30 minutes in recovery room. Anaesthesia was induced using 4-7 mg kg-1 thiopental sodium, l ?g kg -1 fentanyl and 1 mg kg-1 vecuronium for muscle relaxation. Cases were randomized into 2 groups; Group 1 Sevoflurane, Croup 2 Desflurane. End tidal CO2, O2, N2O were monitorized and ventilation were maintained to Keep EtCO2 between 30-40 mmHg. Minimum, maximum, mean heart rates and heart rate variability parameters included low frequency (LF), high frequency (HF) values which are heart rate variability Parameters, LF/HF ratio, Global Sympathetic Index (GSI), R-R intervals were measured in preoperative, intraoperative periods and 2 nd, 10th and 30th minutes after extubation. Atrial and ventricular dysrhythmias (AES, VES) were determined. QT interval was corrected using Bazett's formula (QTc=QT?RR). QT dispersion was calculated by finding shortest and longest QT interval. Results: Assessing data from Holter Monitor maximum heart rates values were significantly higher in Desflurane group (p=0.049). LF/HF ratio, GSI values were higher in Desflurane group in perioperative period except in induction-extubation events. Maximum R-R intervals in Sovoflurane group in perioperative period were significantly higher. In desflurane group QT intervals were significantly longer and QT dispersion was significantly more frequent. Positive correlation between sympathetic tonus increase and YES was recognized in both groups. Conclusion: In this study sympathetic activation was frequently seen in desflurane group, Severe dysrhythmias did not occur in both groups. Although both desflurane and sevoflurane increased the rate of QT, the increased of QTc and QTd in desflurane anesthesia were significantly higher than sevoflurane anesthesia.