The effects of ondansetron versus dexamethasone on electrocardiographic markers of ventricular repolarization in children undergoing cochlear implant.

Autor: Safaeian R; Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran., Hassani V; Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran., Asghari A; Skull Base Research Center, The Five Senses Health Research Institute, Iran University of Medical Sciences, Tehran, Iran., Mohseni M; Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran. Electronic address: Masood.mohseni@gmail.com., Ashraf H; Cardiac Primary Prevention Research Center (CPPRC), Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran., Koleini ZS; Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2020 May; Vol. 132, pp. 109896. Date of Electronic Publication: 2020 Jan 22.
DOI: 10.1016/j.ijporl.2020.109896
Abstrakt: Introduction: Congenital hearing loss is associated with cardiac rhythm disturbances namely long Q-T syndrome. This study was designed to investigate the effect of anti-emetic doses of ondansetron and dexamethasone on ECG recordings in children undergoing cochlear implant surgery.
Methods: Sixty-three pediatric patients scheduled for elective cochlear implantation were enrolled in the study. Two patients were excluded as their baseline ECG showed long QT syndrome. Anesthesia was induced with fentanyl, propofol and atracurium and maintained with propofol. Dexamethasone 0.1 mg.kg -1 or ondansetron 0.2 mg.kg -1 was randomly administered for the participants approximately 30 min before the end of surgery. ECG recording was performed 15 min after induction of anesthesia and 15 min after dexamethasone/ondansetron administration. RR interval, QRS duration, QT interval, and Tp-e interval were measured by a blinded cardiologist.
Results: Ondansetron resulted in no significant changes in RR, JTc and QTc intervals; while prolongedTp-e interval. Multivariable logistic regression analysis showed that use of ondansetron was an independent predictor of QTc prolongation after adjustment for age, gender and baseline QTc (OR = 17.94, CI 95% 1.97-168.70, p = 0.011). The incidence of postoperative retching/vomiting in ondansetron group was significantly lower than dexamethasone group. (3.2% vs. 26.7%, p = 0.011).
Conclusion: The risk of arrhythmias with the use of ondansetron in otherwise healthy candidates of cochlear implant is very low. However, the drug may induce significant changes in ECG parameters. The clinical significance of these changes in patients with cardiac conduction abnormalities should be investigated in further studies.
Competing Interests: Declaration of competing interest None to disclose.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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