Effects of head-up tilt after stellate ganglion block on QT interval and QT dispersion

Reg Anesth Pain Med. 2004 Jul-Aug;29(4):317-22. doi: 10.1016/j.rapm.2004.03.009.

Abstract

Background and objectives: The aim of this study is to examine the effects of head-up tilt (70 degrees ) 30 minutes after right or left stellate ganglion block (SGB) on RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD), and the rate-corrected QT dispersion (QTcD) using computerized measurement.

Methods: Ten healthy volunteers underwent both right and left SGBs using 7 mL 1% mepivacaine with a 7-day interval between the two blocks. A 12-lead electrocardiogram was monitored to measure parameters before SGB; 30 minutes after SGB (before head-up tilt); and immediately, 5, 10, and 15 minutes after head-up tilt.

Results: Right SGB induced significant increases in QT interval, QTc interval, QTD, and QTcD from 30 minutes after the block through 15 minutes after head-up tilt. There were significant increases of QT interval, QTc interval, and QTcD between before and immediately after head-up tilt in right SGB. Left SGB induced significant decreases of QT interval and QTc interval from 30 minutes after SGB through 15 minutes after head-up tilt. Left SGB also induced a significant decrease of QTD from immediately after through 10 minutes after head-up tilt.

Conclusions: Significant increases of QT interval, QTc interval, and QTcD, which are associated with an increased risk of ventricular arrhythmias and cardiac events, occur immediately after head-up tilt in right SGB. However, head-up tilt does not induce increases of QT interval, QTc interval, QTD, and QTcD in left SGB.

MeSH terms

  • Adult
  • Anesthetics, Local / therapeutic use
  • Blood Pressure / physiology
  • Electrocardiography / methods*
  • Heart / physiology*
  • Heart Rate / physiology
  • Humans
  • Male
  • Mepivacaine / therapeutic use
  • Nerve Block / methods*
  • Posture / physiology*
  • Reference Values
  • Stellate Ganglion / drug effects*
  • Supine Position / physiology
  • Tilt-Table Test / methods
  • Time Factors

Substances

  • Anesthetics, Local
  • Mepivacaine