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Effects of long periods of pneumoperitoneum combined with the head-up position on heart rate-corrected QT interval during robotic gastrectomy: an observational study

Authors
 Na Young Kim  ;  Sun-Joon Bai  ;  Hyoung-Il Kim  ;  Jung Hwa Hong  ;  Hoon Jae Nam  ;  Jae Chul Koh  ;  Hyun Joo Kim 
Citation
 JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, Vol.0(0) : 1-10, 2018 
Journal Title
 JOURNAL OF INTERNATIONAL MEDICAL RESEARCH 
ISSN
 0300-0605 
Issue Date
2018
Keywords
Carbon dioxide pneumoperitoneum ; QTc interval ; anaesthesia ; cardiac arrhythmia ; head-up position ; robotic gastrectomy
Abstract
Objective Pneumoperitoneum and the head-up position reportedly stimulate the sympathetic nervous system, potentially increasing the risk of cardiac arrhythmia. We evaluated the effects of a long duration of pneumoperitoneum in the head-up position on the heart rate-corrected QT (QTc) interval during robotic gastrectomy. Methods This prospective observational study involved 28 patients undergoing robotic gastrectomy. The QTc interval was recorded at the following time points: before anaesthetic induction (baseline); 10 minutes after tracheal intubation; 1, 5, 30, 60, and 90 minutes after pneumoperitoneum induction in the head-up position; after pneumoperitoneum desufflation in the supine position; and at the end of surgery. The primary outcome was the QTc interval, which was measured 90 minutes after pneumoperitoneum combined with the head-up position. Results Compared with baseline, the QTc interval was significantly prolonged at 1 and 60 minutes after pneumoperitoneum, peaked at 90 minutes, and was sustained and notably prolonged until the end of surgery. However, no considerable haemodynamic changes developed. Conclusion A long period of carbon dioxide pneumoperitoneum application in a head-up position significantly prolonged the QTc interval during robotic gastrectomy. Therefore, diligent care and close monitoring are required for patients who are susceptible to developing ventricular arrhythmia. TRIAL REGISTRATION: Registered at ClinicalTrials.gov; https://clinicaltrials.gov/ct2/show/NCT02604979 ; Registration number NCT02604979.
Full Text
http://journals.sagepub.com/doi/abs/10.1177/0300060518786914
DOI
10.1177/0300060518786914
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Nam, Hoon Jae(남훈재) ORCID logo https://orcid.org/0000-0001-7112-9221
Bai, Sun Joon(배선준) ORCID logo https://orcid.org/0000-0001-5027-3232
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163272
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