七氟醚和丙泊酚对肥胖患者全麻诱导时P波离散度、QTc及QTc离散度的影响

The effects of anesthesia induction with sevoflurane and propofol on P wave dispersion、 QT interval and QTc dispersion in obese patients' ECG

目的:比较七氟醚与丙泊酚对肥胖患者全麻诱导过程中P波离散度、QTc及QTc离散度的影响。方法:择期行非心脏手术的肥胖患者56例,随机分为七氟醚诱导组(S组)和丙泊酚诱导组(P组),每组28例。两组分别以七氟醚吸入或丙泊酚静脉注射进行全麻诱导。记录麻醉诱导前(基础值)、麻醉诱导第1min、3min、5min的12导联同步心电图。测量P波宽度和QT间期,计算P波离散度(Pwd)和校正后的QT间期(QTc),计算QTc离散度(QTcd)。结果:两组患者麻醉前对照心电图中的Pwd、QT间期及QTc无明显差异;S组诱导后3min和5min最长QTc、最短QTc、QTc、QTcd较诱导前延长;P组诱导后3min和5min最大P波时限、Pwd、最长QTc、最短QTc、QTc、QTcd较诱导前缩短,与S组比较有显著性差异。结论:七氟醚诱导延长肥胖患者QTc和QTcd,而丙泊酚诱导则缩短肥胖患者Pwd、QTc和QTcd。

Objective： To investigate the effects of anesthesia induction with sevoflurane and propofol on P wave dispersion （Pwd）, QT interval and QTc dispersion（QTcd ） on ECG of obese patients. Methods：Fifty-six obese patients undergoing noncardiac surgery, were randomly divided into 2 groups ： sevoflurane group（S） and propofol group（P）. ECG recordings were taken in two groups before induction , at the 1st , 3rd and the fifth minute after induction. P wave duration and QT interval were measured in all ECGs. QTc were determined using the Bazett formula. Pwd and QTcd were then calculated. Results：There was no significant difference in Pwd , QT , QTc interval and QTcd on control ECGs between two groups. In group S, QT , QTc and QTcd were significant prolonged at 3rd and fifth minute after induction compared to control ECGs. In group P, Pwd , QT , QTc and QTcd were significant decreased at 3rd and fifth minute after induction compared to control ECGsand compared to sevoflurane group. Conclusion： Sevoflurane induction can increase QTc in obese patients, but propofol induction decrease Pwd. QTc and QTcd.