Qt Dispersion Effect of Spinal and Epidural Anesthesia

Abstract

Many studies showed that QT interval and QT dispersion are important as a prognostic factor in cardiac and non-cardiac patients. In this study, we aimed to compare effects of the spinal and epidural anaesthesia which are two different model of the central regional anaesthesia on QT interval. Study group was consisted of 60 adult patients who are ASA I-II and planned the regional anesthesia for elective operations. Before the anaesthesia, Multipurpose Digital ECG holter was placed to the patients. Patients randomly divided into two groups as an epidural anaesthesia (n=30) and spinal anaesthesia (n=30). 100 mg 0,5% isobaric bupivacaine (20 ml) was given for epidural anaesthesia and 15 mg 0,5% isobaric bupivacaine (3 ml) was given spinal anaesthesia at the L3 - L4 or L4 - L5 intervertebral spaces. The surgical operation was allowed in patients when the sensory block reached the T10 dermatome level. The preoperative and postoperative hemodynamic parameters, QT intervals and QTa (QT apex) measurements were evaluated. The preoperative heart rate and mean arterial pressure values had decreased during the process without any effect on the hemodynamic stability and this rise was similar in both groups. There was significant increase in the QTa values after regional anaesthesia within the epidural and spinal anaesthesia groups (p<0.05). When the groups were compared in terms of prolonged QTa, significant difference was not founded (p<0.05). QT dispersion is an important noninvasive indicator for deterioration of myocardial homogenity in repolarization and predisposition to the arrhythmia. In our study, the cardiac effects of both methods in terms of QT interval was similar and there was no obvious superiority to another. © 2009 OMÜ Tüm Haklari Saklidir.