EFFECT OF ANAESTHETIC AGENTS ON P-WAVE DISPERSION ON THE ELECTROCARDIOGRAM: COMPARISON OF PROPOFOL AND DESFLURANE

• Published in: Clinical and experimental pharmacology & physiology Vol. 35; no. 9; pp. 1071 - 1076
• Main Authors: Owczuk, Radoslaw, Wujtewicz, Magdalena A, Sawicka, Wioletta, Polak-Krzeminska, Agnieszka, Suszynska-Mosiewicz, Aleksandra, Raczynska, Krystyna, Wujtewicz, Maria
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-09-2008
• Subjects: Adult; Anesthetics - pharmacology; desflurane; Electrocardiography - drug effects; Female; general anaesthesia; Heart Rate - drug effects; Humans; Isoflurane - analogs & derivatives; Isoflurane - pharmacology; Male; Middle Aged; Monitoring, Intraoperative; P-wave dispersion; propofol; Propofol - pharmacology; Young Adult
• ISSN: 0305-1870; 1440-1681
• DOI: 10.1111/j.1440-1681.2008.04963.x

SUMMARY
1
Anaesthetics influence cardiac electrical activity by various mechanisms; thus, they may have pro‐arrhythmic or anti‐arrhythmic actions. Increased P‐wave dispersion is associated with a risk of paroxysmal atrial fibrillation. The aim of the present study was to analyse the impact of propofol and desflurane on changes in P wave dispersion, which may reflect the anti‐arrhythmic effects of these drugs.
2
Fifty patients undergoing scheduled surgery were included in the study. Patients were divided into two equal groups: a propofol group and a desflurane group. Patients in the propofol group were initially administered 2.5 mg/kg propofol, followed by infusion of 6 mg/kg per h propofol. Anaesthesia in the desflurane group was achieved using inhalation induction, with concentrations up to 8–12.5 vol%. When signs of adequate anaesthesia were observed, the concentration of desflurane was reduced to 6 vol%. An electrocardiogram (ECG) was obtained before induction and then again 1, 3 and 5 min after the initiation of propofol infusion or the induction of anaesthesia in the desflurane group; additional measurements were performed after tracheal intubation. P‐wave dispersion was assessed by differences in maximal and minimal P‐wave duration on a 12‐lead ECG.
3
P‐wave dispersion did not change over time in the desflurane group. In the propofol group, there was a significant decrease in P‐wave dispersion after 3 and 5 min of anaesthesia. Significant differences were observed between study groups after 1, 3 and 5 min of anaesthesia, and disappeared after tracheal intubation. Mean and maximal P‐wave duration did not change in either group.
4
In conlcusion, propofol decreases P‐wave dispersion and this seems to be connected with the anti‐arrhythmic properties of the drug.