全麻患者术中静脉注射止吐剂量氟哌利多对QT间期的影响

Effect of antiemetic-dose droperidol on the QT interval during general anesthesia

目的 评价全麻期间静脉注射预防性止吐剂量氟哌利多（0．625mg和1．25mg）对QT间期的影响。方法 60例行腹腔镜胆囊切除术病人，随机分为生理盐水组（C组）、0.625mg氟哌利多组（D1组）和1.25mg氟哌利多组（D2组），每组20例。在麻醉诱导后至外科切皮前，持续记录给药前及给药后10min内每隔1min的标准Ⅱ导联心电图，并分析经心率修正的QT间期（QTc）。记录术中心律失常的发生，术后病人恢复及副作用发生情况。结果给药后3～6min，D1、D2组QT问期分别延长15±40ms和22±41ms，与C组（12±35ms）相比未见统计学差异（P〉0．05）。在给药后10min，三组问较基础值QTc间期延长超过10％的患者数量未见统计学差异。术后三组病人恢复情况和副作用发生率无统计学差异，术中各组均未见心律失常发生。结论 与生理盐水组相比，预防性止吐剂量的氟哌利多未引起全麻术中QT间期显著性延长。

Aim To evaluate the intraoperative effects of small-dose droperidol （0. 625 and 1.25 mg intravenous） on the QT interval when used for antiemetic prophylaxis during general anesthesia. Methods After anesthetic induction and before the surgical incision,60 patients undergoing laparoscopic cholecystectomy procedures were given either saline or 0. 625 or 1.25 mg intravenous droperidol in a total volume of 2 ml. A standard electrocardiographic lead Ⅱ was recorded immediately before and every minute after the injection of the medication during a 10 rain observation period. The QTc （ QT interval corrected for heart rate） was evaluated from the recorded electrocardiographic strips. Any abnormal heartbeats or arrhythmias during the operation were also noted. Results Intravenous droperidol,0. 625 and 1.25 mg,prolonged the QT interval by an average of 15 ±40 ms and 22 ±41 ms, respectively, at 36 min after administration during general anesthesia, but these changes did not differ significantly from that seen with saline （ 12 ± 35 ms）. There were no statistically significant differences among the three study groups in the number of patients with greater than 10% prolongation in QTc （vs. baseline）. Finally, there were no ectopic heartbeats observed on any of the electrocardiographic rhythm strips during the operative period. Conclusions Use of a small dose of droperidol （0. 625 ± 1.25 mg intravenous） for antiemetic prophylaxis during general anesthesia was not associated with a statistically significant increase in the QTc interval compared with saline.