Induction of anesthesia with sevoflurane to coronary artery disease patients' occuring to changes qt interval effect of magnesium

Background and Aim: Anesthesia for coronary artery bypass surgery requires knowledge about physiology, pharmacology and pathophysiology in addition Cardio-pulmonary bypass, myocardial protection and surgical techniques. Patients with have a coronary artery disease tendency to arrhythmias in the perioperative period. The values after 440 ms were evaluated as long QTS. Long QTS disease is a rare disorder that causes quite be mortal especially the patients with ischemic heart this mortality increase 2-5 times. Idiopathic long QTS may be occur iatrogenic or congenital (acquired). In our study, we aimed compare to effect potential antiarrhythmic activity and hemodynamic changes of Mg+2 (Electrocardiography changes, QT prolongation), induction of anesthesia with sevoflurane used routinely in patients with coronary artery disease. Materials and Methods: In this study with the approval of the Ethics Committee, Faculty of Medicine, Inonu University Turgut Ozal Medical Center Hospital with coronary artery disease scheduled for elective coronary artery bypass surgery, age between 40 and 70, ASA II-III, 89 cases were performed. Cases sevoflurane group (Group S, n = 41) and Sevoflurane-Mg+2 group (group SM, n = 48) were divided in two. Patients in Group S 8 L / min of oxygen/medical air mixture were ventilated with sevoflurane so that the FiO2:0.3. When sevoflurane end-tidal rate 2.5% is started 50 mg / kg Mg+2 infusion that continue over 20 min in group SM. Patients parametres pulse, blood pressure, oxygen saturation, electrocardiography changes were recorded with 6 different time point. T1 (Introduction): the patient immediately after enter the operation room, T2: Sevoflurane-Mg+2 sulphate infusion ends, T3: immediately before intubation, T4: after intubation 30 seconds later, T5: after intubation 1 minutes later, T6: after intubation 5 minutes later. Results: The patients? age, weight, height and similar in terms of gender (Table, 1). QTc interval in both groups compared with baseline in all periods were significantly increased within the group but there were no significant difference between the groups in the evaluation. QTc interval was increased T5 and T6 periods based on T3 period in Group S. And this significantly increase in Group SM was similar the periods of T4, T5 and T6 based on T3. Tp-e interval values was no significant difference between the groups and within the groups at all periods. In both groups mean arterial pressure values were significantly decreased in all periods based on the input value. The decrease was greater in Group SM. Mean arterial pressure values were significantly increased in both groups periods of T4, T5 and T6 based on T3 period. This increase was greater in Group S. heart rate all periods by the input value significantly decreased in both groups, this decreased significantly higher T3, T4 and T5 in Group SM. Heart rate significantly increased T4 and T5 based on T3 in Group S and T4, T5 and T6 based on T3 in Group SM. This increase was greater in Group S for the period T4. Conclusion: In patients with coronary artery disease induction of anesthesia with sevoflurane extends QTc interval and Tp-e interval. Use Mg+2 bolus of 50 mg / kg did not effect this change. Both drugs used safely and Mg+2 was more suppressed hemodynamic response to intubation. Keywords: Coronary Artery Disease, Sevoflurane, Magnesium, QT Interval