Anaesthesia and the QT interval in humans: effects of halothane and isoflurane in premedicated children

Eur J Anaesthesiol. 1998 Nov;15(6):623-8. doi: 10.1097/00003643-199811000-00001.

Abstract

The effects of halothane and isoflurane followed by subsequent administration of vecuronium on the QT interval have been investigated during the induction of anaesthesia. Fifty-eight children, ASA I, without cardiovascular and electrolyte abnormalities and not receiving any medication were studied. Anaesthesia was induced with either halothane (n = 28) or isoflurane (n = 30), and was maintained until the end of the study with end-tidal concentrations of 2.5-3%. Recordings of ECG, heart rate and systolic arterial pressure were obtained at the following times: prior to induction of anaesthesia; 1 and 3 min after stable end-tidal concentrations of the induction agent had been reached; 1 and 3 min following vecuronium administration; at the time of tracheal intubation; 1 and 3 min later. Halothane significantly shortened the QTc interval (P < 0.05); isoflurane prolonged it (P < 0.001). Heart rate decreased significantly after halothane administration (P < 0.01); in contrast, heart rate increased after induction of anaesthesia with isoflurane (P < 0.05), increasing further after laryngoscopy and tracheal intubation (P < 0.001). Systolic arterial pressure decreased significantly (P < 0.001) in both groups after induction of anaesthesia and remained decreased until the end of the study. It is concluded that halothane may be a better choice than isoflurane for children with a long QT interval.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anesthetics, Inhalation / pharmacology*
  • Blood Pressure / drug effects
  • Child, Preschool
  • Electrocardiography / drug effects*
  • Female
  • Halothane / pharmacology*
  • Heart Rate / drug effects
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Infant
  • Isoflurane / pharmacology*
  • Long QT Syndrome / physiopathology
  • Male
  • Midazolam / administration & dosage
  • Neuromuscular Nondepolarizing Agents / pharmacology
  • Preanesthetic Medication*
  • Vecuronium Bromide / pharmacology

Substances

  • Anesthetics, Inhalation
  • Hypnotics and Sedatives
  • Neuromuscular Nondepolarizing Agents
  • Vecuronium Bromide
  • Isoflurane
  • Midazolam
  • Halothane