Impact of thoracic epidural sympathetic block on cardiac repolarization
PURPOSEThe interval from the peak to the end of the T wave (Tp-Te) on electrocardiography is considered a marker of ventricular arrhythmias. A previous study suggested that right stellate ganglion block prolonged QT and QT dispersion (QTD). We investigated the effect of thoracic epidural sympathetic...
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| Veröffentlicht in: | Local and regional anesthesia 2018-10, Vol.11, p.81-85 |
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| creator | Komatsuzaki, Makoto Takasusuki, Toshifumi Yamaguchi, Shigeki |
| description | PURPOSEThe interval from the peak to the end of the T wave (Tp-Te) on electrocardiography is considered a marker of ventricular arrhythmias. A previous study suggested that right stellate ganglion block prolonged QT and QT dispersion (QTD). We investigated the effect of thoracic epidural sympathetic block with 1% mepivacaine on QT, QTD, Tp-Te, and Tp-Te/QT by using computerized measurement. PATIENTS AND METHODSAfter obtaining the approval of the ethics committee of Dokkyo Medical University Hospital, 23 patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo thoracic surgery were enrolled. An epidural catheter was inserted at the Th4-5 or 5-6 level and then used for injection of 7 mL of 1% mepivacaine. Changes in RR interval, QT, corrected QT (QTc), QTD, QTc dispersion (QTcD), Tp-Te, Tp-Te/QT, and Tp-Te/QTc before and after epidural injection were assessed by computerized measurement. Statistical analysis was performed by one-way ANOVA. RESULTSSystolic blood pressure was consistently suppressed 10-15 minutes after injection (baseline: 136±10 mmHg, 11 minutes: 113±12 mmHg, 12 minutes: 112±13 mmHg, 13 minutes: 112±12 mmHg, 14 minutes: 108±17 mmHg, 15 minutes: 111±14 mmHg; P |
| doi_str_mv | 10.2147/LRA.SI82402 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6200079</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2132275821</sourcerecordid><originalsourceid>FETCH-LOGICAL-p889-fe96124a7bea7dac28f11245f21fdb38e186d29907e01963d705686af8ea3aca3</originalsourceid><addsrcrecordid>eNpVj0tLAzEUhYMoVmpX_oEs3UxNMo8kG6EUrYWCoN0Pd_Kw0ZnJmMkI9dcbsAs9m3O4Bz7OReiGkiWjBb_bvayWr1vBCsLO0BWlXGScUnb-J8_QYhzfSVJJGK-KSzTLSUFJLukV2my7AVTE3uJ48AGUU9gMTk8BWjweUxkPJqZj03r1gX2PFQTtQOFgBt9CcN8Qne-v0YWFdjSLk8_R_vFhv37Kds-b7Xq1ywYhZGaNrCgrgDcGuAbFhE0Di9IyanWTC0NFpZmUhBtCZZVrTspKVGCFgRwU5HN0_4sdpqYzWpk-pqH1EFwH4Vh7cPX_pneH-s1_1RVL_3OZALcnQPCfkxlj3blRmbaF3vhprBnNGeOlSP4D8mNo7A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2132275821</pqid></control><display><type>article</type><title>Impact of thoracic epidural sympathetic block on cardiac repolarization</title><source>Taylor & Francis Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Dove Press Free</source><source>PubMed Central Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Komatsuzaki, Makoto ; Takasusuki, Toshifumi ; Yamaguchi, Shigeki</creator><creatorcontrib>Komatsuzaki, Makoto ; Takasusuki, Toshifumi ; Yamaguchi, Shigeki</creatorcontrib><description>PURPOSEThe interval from the peak to the end of the T wave (Tp-Te) on electrocardiography is considered a marker of ventricular arrhythmias. A previous study suggested that right stellate ganglion block prolonged QT and QT dispersion (QTD). We investigated the effect of thoracic epidural sympathetic block with 1% mepivacaine on QT, QTD, Tp-Te, and Tp-Te/QT by using computerized measurement. PATIENTS AND METHODSAfter obtaining the approval of the ethics committee of Dokkyo Medical University Hospital, 23 patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo thoracic surgery were enrolled. An epidural catheter was inserted at the Th4-5 or 5-6 level and then used for injection of 7 mL of 1% mepivacaine. Changes in RR interval, QT, corrected QT (QTc), QTD, QTc dispersion (QTcD), Tp-Te, Tp-Te/QT, and Tp-Te/QTc before and after epidural injection were assessed by computerized measurement. Statistical analysis was performed by one-way ANOVA. RESULTSSystolic blood pressure was consistently suppressed 10-15 minutes after injection (baseline: 136±10 mmHg, 11 minutes: 113±12 mmHg, 12 minutes: 112±13 mmHg, 13 minutes: 112±12 mmHg, 14 minutes: 108±17 mmHg, 15 minutes: 111±14 mmHg; P<0.05). However, RR interval, QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, and Tp-Te/QTc were not changed after epidural block. CONCLUSIONThoracic epidural injection of 1% mepivacaine did not alter QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, or Tp-Te/QTc. These results emphasize the safety of thoracic epidural sympathetic block with 1% mepivacaine for patients compared with right stellate ganglion block, in terms of cardiac repolarization.</description><identifier>ISSN: 1178-7112</identifier><identifier>EISSN: 1178-7112</identifier><identifier>DOI: 10.2147/LRA.SI82402</identifier><identifier>PMID: 30410391</identifier><language>eng</language><publisher>Dove Medical Press</publisher><subject>Original Research</subject><ispartof>Local and regional anesthesia, 2018-10, Vol.11, p.81-85</ispartof><rights>2018 Komatsuzaki et al. This work is published and licensed by Dove Medical Press Limited 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200079/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200079/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Komatsuzaki, Makoto</creatorcontrib><creatorcontrib>Takasusuki, Toshifumi</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><title>Impact of thoracic epidural sympathetic block on cardiac repolarization</title><title>Local and regional anesthesia</title><description>PURPOSEThe interval from the peak to the end of the T wave (Tp-Te) on electrocardiography is considered a marker of ventricular arrhythmias. A previous study suggested that right stellate ganglion block prolonged QT and QT dispersion (QTD). We investigated the effect of thoracic epidural sympathetic block with 1% mepivacaine on QT, QTD, Tp-Te, and Tp-Te/QT by using computerized measurement. PATIENTS AND METHODSAfter obtaining the approval of the ethics committee of Dokkyo Medical University Hospital, 23 patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo thoracic surgery were enrolled. An epidural catheter was inserted at the Th4-5 or 5-6 level and then used for injection of 7 mL of 1% mepivacaine. Changes in RR interval, QT, corrected QT (QTc), QTD, QTc dispersion (QTcD), Tp-Te, Tp-Te/QT, and Tp-Te/QTc before and after epidural injection were assessed by computerized measurement. Statistical analysis was performed by one-way ANOVA. RESULTSSystolic blood pressure was consistently suppressed 10-15 minutes after injection (baseline: 136±10 mmHg, 11 minutes: 113±12 mmHg, 12 minutes: 112±13 mmHg, 13 minutes: 112±12 mmHg, 14 minutes: 108±17 mmHg, 15 minutes: 111±14 mmHg; P<0.05). However, RR interval, QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, and Tp-Te/QTc were not changed after epidural block. CONCLUSIONThoracic epidural injection of 1% mepivacaine did not alter QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, or Tp-Te/QTc. These results emphasize the safety of thoracic epidural sympathetic block with 1% mepivacaine for patients compared with right stellate ganglion block, in terms of cardiac repolarization.</description><subject>Original Research</subject><issn>1178-7112</issn><issn>1178-7112</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpVj0tLAzEUhYMoVmpX_oEs3UxNMo8kG6EUrYWCoN0Pd_Kw0ZnJmMkI9dcbsAs9m3O4Bz7OReiGkiWjBb_bvayWr1vBCsLO0BWlXGScUnb-J8_QYhzfSVJJGK-KSzTLSUFJLukV2my7AVTE3uJ48AGUU9gMTk8BWjweUxkPJqZj03r1gX2PFQTtQOFgBt9CcN8Qne-v0YWFdjSLk8_R_vFhv37Kds-b7Xq1ywYhZGaNrCgrgDcGuAbFhE0Di9IyanWTC0NFpZmUhBtCZZVrTspKVGCFgRwU5HN0_4sdpqYzWpk-pqH1EFwH4Vh7cPX_pneH-s1_1RVL_3OZALcnQPCfkxlj3blRmbaF3vhprBnNGeOlSP4D8mNo7A</recordid><startdate>20181016</startdate><enddate>20181016</enddate><creator>Komatsuzaki, Makoto</creator><creator>Takasusuki, Toshifumi</creator><creator>Yamaguchi, Shigeki</creator><general>Dove Medical Press</general><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181016</creationdate><title>Impact of thoracic epidural sympathetic block on cardiac repolarization</title><author>Komatsuzaki, Makoto ; Takasusuki, Toshifumi ; Yamaguchi, Shigeki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p889-fe96124a7bea7dac28f11245f21fdb38e186d29907e01963d705686af8ea3aca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Original Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Komatsuzaki, Makoto</creatorcontrib><creatorcontrib>Takasusuki, Toshifumi</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Local and regional anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Komatsuzaki, Makoto</au><au>Takasusuki, Toshifumi</au><au>Yamaguchi, Shigeki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of thoracic epidural sympathetic block on cardiac repolarization</atitle><jtitle>Local and regional anesthesia</jtitle><date>2018-10-16</date><risdate>2018</risdate><volume>11</volume><spage>81</spage><epage>85</epage><pages>81-85</pages><issn>1178-7112</issn><eissn>1178-7112</eissn><abstract>PURPOSEThe interval from the peak to the end of the T wave (Tp-Te) on electrocardiography is considered a marker of ventricular arrhythmias. A previous study suggested that right stellate ganglion block prolonged QT and QT dispersion (QTD). We investigated the effect of thoracic epidural sympathetic block with 1% mepivacaine on QT, QTD, Tp-Te, and Tp-Te/QT by using computerized measurement. PATIENTS AND METHODSAfter obtaining the approval of the ethics committee of Dokkyo Medical University Hospital, 23 patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo thoracic surgery were enrolled. An epidural catheter was inserted at the Th4-5 or 5-6 level and then used for injection of 7 mL of 1% mepivacaine. Changes in RR interval, QT, corrected QT (QTc), QTD, QTc dispersion (QTcD), Tp-Te, Tp-Te/QT, and Tp-Te/QTc before and after epidural injection were assessed by computerized measurement. Statistical analysis was performed by one-way ANOVA. RESULTSSystolic blood pressure was consistently suppressed 10-15 minutes after injection (baseline: 136±10 mmHg, 11 minutes: 113±12 mmHg, 12 minutes: 112±13 mmHg, 13 minutes: 112±12 mmHg, 14 minutes: 108±17 mmHg, 15 minutes: 111±14 mmHg; P<0.05). However, RR interval, QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, and Tp-Te/QTc were not changed after epidural block. CONCLUSIONThoracic epidural injection of 1% mepivacaine did not alter QT, QTc, QTD, QTcD, Tp-Te, Tp-Te/QT, or Tp-Te/QTc. These results emphasize the safety of thoracic epidural sympathetic block with 1% mepivacaine for patients compared with right stellate ganglion block, in terms of cardiac repolarization.</abstract><pub>Dove Medical Press</pub><pmid>30410391</pmid><doi>10.2147/LRA.SI82402</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Original Research |
| title | Impact of thoracic epidural sympathetic block on cardiac repolarization |
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