Arrhythmia incidence and associated factors during volatile induction of general anesthesia with sevoflurane: a retrospective analysis of 950 adult patients - 09/06/21
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Highlights |
• | Incidence of arrhythmia during induction of anesthesia with sevoflurane was 17.3% in adults. |
• | High sevoflurane concentration may be associated with arrhythmia during induction. |
• | Careful control of sevoflurane concentration during induction is required. |
Abstract |
Background |
Sevoflurane has been used to induce anaesthesia in adults due to its suitability for airway management and haemodynamic stability. Few studies have reported arrhythmia during volatile induction with sevoflurane in adults. Here, we investigated the incidence of arrhythmia and risk factors associated with its occurrence during sevoflurane induction of anaesthesia in adults.
Patients and Methods |
We retrospectively analysed 950 adult patients who underwent elective ear nose and throat surgery with volatile induction using sevoflurane between May and December 2015. The incidence of arrhythmia and the factors associated with its development were analysed.
Results |
Arrhythmia was observed in 164 (17.3%) of 950 adult patients. The most frequently observed arrhythmia was sinus tachycardia (heart rate > 120 bpm) (77 patients, 47.0%). The multivariable logistic analysis showed four independent risk factors: age (odds ratio [OR] = 0.984, 95% confidence interval [CI] = 0.973−0.996, p = 0.006), coronary artery disease (OR = 3.749, 95% CI = 1.574–8.927, p = 0.003), maximal concentration (8 vol%) of sevoflurane from the start of induction (OR = 2.696, 95% CI = 1.139–6.382, p = 0.024), and maintenance of 8 vol% sevoflurane concentration after eyelash reflex loss (OR = 1.577, 95% CI = 1.083–2.296, p = 0.018). The risk of hypotension was greater in patients in whom arrhythmia occurred, although blood pressure recovered to baseline after the concentration of sevoflurane was adjusted.
Conclusions |
We recommend that the sevoflurane concentration be gradually increased with continuous and vigilant electrocardiogram and blood pressure monitoring. The sevoflurane concentration should be adjusted after sufficient unconsciousness is reached.
El texto completo de este artículo está disponible en PDF.Abbreviations : ANOVA, ASA, CAD, CI, COPD, ECG, ENT, ETCO2, OR, SpO2, PAC, QTc, VCRII
Keywords : Sevoflurane, Inhalation anaesthesia, Arrhythmia, Risk factor
Esquema
| ☆ | This work was presented in part as J. Baik's M.S. thesis at the University of Ulsan College of Medicine (2017). |
| ☆☆ | This work was partly presented at the 34th Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine held in Malmö, Sweden (2017). |
Vol 40 - N° 3
Artículo 100878- juin 2021 Regresar al número
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