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QT interval and QT dispersion increase in the elderly during laparoscopic cholecystectomy: a preliminary study

[L’intervalle QT et la dispersion du QT s’accentuent chez les patients âgés pendant la cholécystectomie laparoscopique : une étude préliminaire]

Hirotoshi Egawa, MD^*, Junichi Minami, MD, Kouichi Fujii, MD^*, Shinsuke Hamaguchi, MD^*, Yasuhisa Okuda, MD^* and Toshimitsu Kitajima, MD^*

^* From the Department of Anesthesiology, and Hypertension and
Cardiorenal Medicine, Dokkyo University School of Medicine, Tochigi, Japan.

Dr. Hirotoshi Egawa, Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan. Phone: 81-28-286-1111; Fax: 81-28-286-0478; E-mail: egawa718{at}maple.ocn.ne.jp

Purpose: To compare the influence of a longer duration of intraperitoneal CO₂ insufflation with head-up tilt on electrocardiogram indices during laparoscopic cholecystectomy between elderly and younger patients.

Methods: Twelve elderly and 12 younger patients were studied. In all patients, intraperitoneal CO₂ insufflation was performed for more than 150 min in the head-up position. RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD) and the rate-corrected QTD (QTcD) were measured.

Results: The QT interval and the QTc interval increased significantly from 120 to 150 min after CO₂ insufflation in the elderly. The QTD and QTcD increased significantly during CO₂ insufflation in both groups. Those were significantly greater in the elderly than in younger patients from 120 to 150 min after CO₂ insufflation.

Conclusion: Longer duration of CO₂ insufflation with head-up tilt is associated with a prolongation of the QT interval and the QTD in elderly patients. The clinical significance of these findings remains to be determined.