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

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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.

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