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Arrhythmia incidence and associated factors during volatile induction of general anesthesia with sevoflurane: a retrospective analysis of 950 adult patients

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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. (C) 2021 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
Author(s)
구승우김성훈남수근백재원윤정필조민수조준영최성수
Issued Date
2021
Type
Article
Keyword
ArrhythmiaInhalation anaesthesiaRisk factor Sevoflurane
DOI
10.1016/j.accpm.2021.100878
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7281
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2524878774&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Arrhythmia%20incidence%20and%20associated%20factors%20during%20volatile%20induction%20of%20general%20anesthesia%20with%20sevoflurane:%20a%20retrospective%20analysis%20of%20950%20adult%20patients&offset=0&pcAvailability=true
Publisher
ANAESTHESIA CRITICAL CARE PAIN MEDICINE
Location
프랑스
Language
영어
ISSN
2352-5568
Citation Volume
40
Citation Number
3
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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