Efeito de levobupivacaína e bupivacaína nas dispersões da onda P, QT e QT corrigido (QTc) em cesariana

Yeliz Deniz; Dilek Okyay; Volkan Hancı; Serhan Yurtlu; Hilal Ayoğ; lu; Iş; ı; l Özkoçak Turan

doi:10.1590/S0034-70942013000200008

Scientific Article

Efeito de levobupivacaína e bupivacaína nas dispersões da onda P, QT e QT corrigido (QTc) em cesariana

The Effect of levobupivacaine and bupivacaine on QT, corrected QT (Qtc), and P wave dispersions in cesarean section

Yeliz Deniz; Dilek Okyay; Volkan Hancı; ; Serhan Yurtlu; Hilal Ayoğ; lu; Iş; ı; l Özkoçak Turan

http://dx.doi.org/10.1590/S0034-70942013000200008 Braz J Anesthesiol, vol.63, n2, p.202-208, 2013

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OBJETIVOS E JUSTIFICATIVA: Nosso estudo teve como objetivo investigar o efeito de bupivacaína e levobupivacaína na duração das dispersões do QT, QT corrigido (QTc) e da onda P durante raquianestesia em cesariana. MÉTODOS: Sessenta parturientes programadas para cesariana eletiva ASA I-II foram incluídas no estudo. Exames eletrocardiográficos (ECG) foram feitos após a entrada das pacientes na sala de operação. Frequência cardíaca (FC), pressão arterial não invasiva (PANI), saturação periférica de oxigênio (SpO2) e frequência respiratória (RR) foram registradas. Para o acesso venoso, uma cânula de calibre 18G foi usada. A pré-carga de líquidos foi feita com solução de Ringer com lactato (10 mL.kg-1). Após a pré-carga de líquidos, um segundo exame eletrocardiográfico foi feito e as pacientes foram designadas aleatoriamente para dois grupos. O Grupo B (n = 30) recebeu 10 mg de bupivacaína e o Grupo L (n = 30) recebeu 10 mg de levobupivacaína para raquianestesia. Exames ECG foram repetidos nos minutos um, cinco e 10 após a anestesia. FC, PANI, SpO2, FR e os níveis de bloqueio sensorial também foram registrados nos mesmos intervalos de tempo. Em intervalos de tempo pré-determinados de raquianestesia, as durações da dispersão da onda P (OPd), QT (QTd) e QTc (QTcd) foram medidas a partir dos registros do ECG. As durações de QT e QTc foram calculadas com a fórmula de Bazzett. RESULTADOS: Não houve diferença entre os dois grupos quanto aos níveis de bloqueio, parâmetros hemodinâmicos, OPd, QTd, QTc e QTcd. CONCLUSÃO: Levobupivacaína e bupivacaína podem ser os anestésicos de escolha para raquianestesia em grávidas com dispersões prolongadas da OPd e QTcd no período pré-operatório.

Palavras-chave

ANESTESIA, Regional, raquianestesia, ANESTÉSICOS, Local, bupivacaína, levobupivacaína, CIRURGIA, Cesárea, Eletrocardiografia

Abstract

BACKGROUND AND OBJECTIVES: In our study we aimed to investigate the effect of bupivacaine and levobupivacaine on QT, corrected QT (QTc), and P wave dispersion durations during spinal anesthesia in cesarean section. METHODS: Sixty parturients scheduled for elective cesarean section in ASA I-II risk groups were included in the study. Baseline electrocardiographic (ECG) records of the patients were obtained in the operation room. Heart rate (HR), non-invasive blood pressure (NIBP), peripheral oxygen saturation (SpO2) and respiration rates (RR) were recorded. Venous cannulation was performed with 18G cannula and fluid preload made with 10 mL.kg-1. Lactated Ringer solution. After fluid preload, second ECG recordings were taken and the patients were randomly separated into two groups. Group B (n = 30) received 10 mg of bupivacaine and Group L (n = 30) received 10 mg of levobupivacaine for spinal anesthesia. ECG recordings were repeated at 1, 5 and 10 minutes after spinal block. HR, NIBP, SpO2 , RR and sensory block levels were also recorded at the same time intervals. At predetermined time intervals of spinal anesthesia, P wave dispersion (Pwd), QT dispersion (QTd), and QTc dispersion (QTcd) durations were measured from ECG records. QT and QTc durations are calculated with Bazzett formula. RESULTS: There was no difference between two groups according to block levels, hemodynamic parameters, Pwd, QTd, QTc and QTcd durations. CONCLUSION: Bupivacaine and levobupivacaine may be preferred in spinal anesthesia in pregnant patients who have extended Pwd and QTcd preoperatively.

Keywords

Anesthesia, Spinal, Cesarean Section, Bupivacaine/ levobupivacaine, Electrocardiography

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Efeito de levobupivacaína e bupivacaína nas dispersões da onda P, QT e QT corrigido (QTc) em cesariana

The Effect of levobupivacaine and bupivacaine on QT, corrected QT (Qtc), and P wave dispersions in cesarean section

Yeliz Deniz; Dilek Okyay; Volkan Hancı; ; Serhan Yurtlu; Hilal Ayoğ; lu; Iş; ı; l Özkoçak Turan

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