Effect of anaesthetic agents on p-wave dispersion on the electrocardiogram: comparison of propofol and desflurane

Clin Exp Pharmacol Physiol. 2008 Sep;35(9):1071-6. doi: 10.1111/j.1440-1681.2008.04963.x. Epub 2008 May 25.

Abstract

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. 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. 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. In conclusion, propofol decreases P-wave dispersion and this seems to be connected with the anti-arrhythmic properties of the drug.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Anesthetics / pharmacology*
  • Desflurane
  • Electrocardiography / drug effects*
  • Female
  • Heart Rate / drug effects
  • Humans
  • Isoflurane / analogs & derivatives*
  • Isoflurane / pharmacology
  • Male
  • Middle Aged
  • Monitoring, Intraoperative
  • Propofol / pharmacology*
  • Young Adult

Substances

  • Anesthetics
  • Desflurane
  • Isoflurane
  • Propofol