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Objective To evaluate the effects of preoperative prophylactic infusion of cephalosporins antibiotics on electrocardiogram(ECG)during anesthesia induction with propofol. Methods Fifty female patients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 20-50 yr,weighing 43-75kg,scheduled for elective surgery,were divided into cefuroxime sodium group(group CEFU)and cefathiamidine group(group CEFA),with 25 patients in each group. After cefuroxime sodium was infused in group CEFU or cefathiamidine was infused in group CEFA,propofol was given by target-controlled infusion(plasma concentration 4 μg/ml).Before infusion of cefuroxime sodium or cefathiamidine,after completion of infusion and at 5min after propofol reached the target concentration,12-lead ECG was recorded,and mean arterial pressure and heart rate were simultaneously recorded. Tp-e interval and Tp-e/QT ratio were calculated.Results Compared with the baseline before infusion of cefuroxime sodium or cefathiamidine,Tp-e interval was significantly prolonged after completion of infusion and at 5min after propofol reached the target concentration in group CEFU,and Tp-e interval was significantly prolonged,and Tp-e/QT ratio was enlarged in group CEFA(P0.05).Conclusion Preoperative prophylactic infusion of cefuroxime sodium produces less ECG interference than preoperative prophylactic infusion of cefathiamidine during anesthesia induction with propofol.
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Objective To evaluate the effects of different target plasma concentrations of propofol on ventricular repolarization in elderly patients.Methods Forty-five patients,aged 65-80 yr,weighing 43-85 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were divided into 3 groups (n=15 each) using a random number table:propofol at target plasma concentration of 2 μg/ml group (group P1),propofol at target plasma concentration of 3 μg/ml group (group P2) and propofol at target plasma concentration of 4 μg/ml group (group P3).Before induction of anesthesia (T1) and at 5 min after propofol reached the target plasma concentration (T2),12-lead electrocardiogram was recorded,the QT and Tp-e intervals were measured,and the corrected QT (QTc) interval and Tp-e/QT ratio were calculated.Results There were no significant differences in QTc interval,Tp-e interval or Tp-e/QT ratio at T1,2 between the three groups (P＞0.05).Compared with those at T1,the QTc and Tp-e intervals were significantly shortened and the Tp-e/QT ratio was decreased at T2 in P1 and P2 groups,and the Tp-e interval was shorten and the Tp-e/QT ratio was decreased at T2 (P＜ 0.05),and no significant change was found in the QTc interval at T2 in group P3 (P＞0.05).Conclusion Propofol at clinically relevant concentrations can shorten the ventricular repolarization in elderly patients.
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Objective To observe the effect of CO2 pneumoperitoneum combined with position changes on the stability of cardiac electrophysiology in gynecological laparoscopy. Methods The gynecological laparoscopy was performed for 30 patients to undergo elective gynecological laparoscopy under general anesthesia ,with the pneumoperitoneum pressure of 12 mmHg and the Trendelenburg positionat 15° . The observations and analyses were done over the basic monitoring index and the QT interval (QT),T peak tend interval (Tp-e),heart rate corrected QT interval(QTc),QT dispersion(QTd),Tp-e/QT before anesthesia(T0),after anesthesia(T1),1 min after pneumoperitoneum (T2),30 min after pneumoperitoneum and head-down tilt (T3),30 min after deflation and supine position(T4). Results Compared with the time point of T0,QTd increased significantly at T1(P<0.05) and so it was with QT,QTc,QTd,Tp-e,Tp-e/QT at T2,T3,and T4(P<0.05). Compared with the time point of T2,QTc,QTd,Tp-e,Tp-e/QT significantly increased at T3(P < 0.05). Conclusions CO2 pneumoperitoneum combined with Trendelenburg position can prolong ventricular repolarization duration and destroy the stability of cardiac electrophysiology so it may increase the incidence of cardiovascular events.
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Objective To investigate the effects of target-controlled confusion of propofol with different concentrations on ventricular repolarization after prophylactic infusion of cefuroxime sodium. Methods Sixty ASA physical status Ⅰ or Ⅱ female patients,aged 18-65 years,undergoing elective gynecological surgery were randomly divided into three groups:group P2 (n =20)with TCI 2 μg/ml, group P3 (n =1 9)with TCI 3 μg/ml and group P4 (n =20)with TCI 4 μg/ml.Firstly,they were re-hydrated;secondly,the patients in groups P2,P3 and P4 were intravenous infused with cefuroxime sodium 2.5 g (in 100 ml normal saline)and then target-controlled infused of propofol 2 μg/ml,3μg/ml and 4 μg/ml in target plasma concentration,respectively.At three pionts of time:after rehy-dration before intravenous antibiotics (T0 ),after intravenous antibiotics before TCI of propofol (T1 ), after TCI of propofol (T2 ),QT interval,QTc interval,Tp-e interval were measured and recorded, respectively.Results Compared with T0 ,QTc [(469.9 ± 34.0)ms vs.(451.2 ± 24.9)ms],Tp-e [(107±25)ms vs.(94±20)ms]and Tp-e/QT (0.260±0.058 vs.0.236±0.043)in group P4 were sig-nificantly prolonged at T1 (P < 0.05 ).Compared with T1 ,QTc of groups P2 [(437.4 ± 24.4)ms vs. (453.3±28.0)ms]and P4 [(438.8±29.9)ms vs.(469.9±34.0)ms]were shortened significantly at T2 (P <0.05).Conclusion Propofol could improve ventricular reporlarization heterogeneity caused by cefu-roxime sodium.