Comparison of the effects of propofol plus fentanyl with midazolam plus fentanyl on pr, qtc interval and qt dispersion in patients undergoing coronary artery surgery

Abstract

AimTo compare the effects of propofol and midazolam on markers of myo-cardial homogeneity when used during anesthesia induction in patients un-dergoing coronary artery bypass grafting.MethodA total of 50 patients with normal left ventricular systolic function and normal electro-cardiogram were randomized into two groups as to receive propofol Group 1 (n=25, mean age: 68.28±10.44) or midazolam (n=25, mean age: 67.88±8.90) during induction of anesthesia. Standard 12-lead electrocardiograms were obtained just before induction of anesthesia to ensure baseline compara-bility of two groups. Patients were monitored with an ambulatory electro-cardiogram before and after surgery, and individual average QT duration, QTc duration, P dispersion and QT dispersion were calculated.ResultsDis-tribution of baseline characteristics were similar between two groups. Two groups were also similar regarding preoperative QT duration, QTc duration, QT dispersion and p-wave dispersion. Mean of individual average QT dura-tion, QTc duration, and P dispersion did not differ significantly between two groups whereas mean of individual average QT dispersion was significantly higher in propofol group than that in midazolam group in the postoperative period (32.80±13.07 vs. 24.60±9.34, in Group 1 and 2, respectively, p=0.01).ConclusionMidazolam seems to have minimal effect on the electrical stabil-ity of the myocardium, whereas propofol is likely to limit recovery of myo-cardial homogeneity after CABG to some extent when used during induction of anesthesia.

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