THE INFLUENCE OF SPINAL ANESTHESIA ON THE PROLONGATION OF THE QT INTERVAL IN PATIENTS WITH DIABETES MELLITUS
Keywords:
Corrected QT interval, Diabetes Mellitus, Long QT Syndrome, Spinal Anesthesia, Spinal BlockadeAbstract
The aim of this study was to investigate the effect of spinal blockade on the QTc interval in patients with and without diabetes mellitus, considering the known impact of spinal anesthesia and autonomic neuropathy on QTc interval prolongation. Both spinal anesthesia and autonomic neuropathy, often observed in diabetes mellitus, are associated with QTc interval prolongation. However, the specific impact of spinal blockade on the duration of the QTc interval in individuals with diabetes had not been thoroughly studied. We hypothesized that patients with diabetes would experience greater QTc interval prolongation after spinal blockade compared to non-diabetic patients. In this prospective observational study conducted at a tertiary-level university clinic: SamSMU multi-profile clinic, 48 participants were divided into two groups: with diabetes mellitus (DM group, n=24) and without it (control group, n=24). All subjects underwent spinal anesthesia. Measurements of the QTc interval, the interval from the peak to the end of the T wave (Tp-e interval), heart rate variability, blood pressure, and heart rate were recorded at baseline (T1) and 1 (T2), 5 (T3), and 10 minutes (T4) after spinal blockade. Our findings suggest that patients with diabetes experience more pronounced QTc interval prolongation after spinal anesthesia compared to non-diabetic patients. These results underscore the importance of monitoring cardiac electrical activity in patients with diabetes.
References
Basques, B.A., Bohl, D.D., Golinvaux, N.S., Samuel, A.M., & Grauer, J.G. (2015). General versus spinal anaesthesia for patients aged 70 years and older with a fracture of the hip. Bone Joint J, 97-B, 689–695.
Elming, H., Brendorp, B., Køber, L., Sahebzadah, N., & Torp-Petersen, C. (2002). QTc interval in the assessment of cardiac risk. Card Electrophysiol Rev, 6, 289–294.
G’oyibov, S. S., & Nematulloev, T. K. (2023). REVIEW OF NEURAXIAL TECHNIQUES IN ANAESTHESIA: RISKS, CAUSES, AND RECOMMENDATIONS FOR SPINAL CORD INJURIES (in Russ). World Scientific Research Journal, 20(1), 145-155.
Gowda, R.M., Khan, I.A., Wilbur, S.L., Vasavada, B.C., & Sacchi, T.J. (2004). Torsade de pointes: the clinical considerations. Int J Cardiol, 96, 1–6.
Goyibov, S.S., & Nematulloev, T.K. (2023). DETERMINANTS OF PERIOPERATIVE OUTCOMES IN COLORECTAL SURGERY: THE ROLE OF COMORBIDITY AND CONGESTIVE HEART FAILURE. Journal of Hepato-Gastroenterological Research, 4(2).
Matlubov, M., & Nematulloev, T. (2022). MAIN HEMODYNAMIC PATTERNS IN OVERWEIGHT PATIENTS DURING PROCTOLOGICAL SURGERY (in Russ). Science and Innovation, 1(6), 263-270.
Matlubov, M.M., & Nematulloev, T.K. (2022). CONSISTENCY OF HEMODYNAMICS IN PREGNANT WOMEN WITH OBESITY. Achievements of Science and Education, 6(86), 31-34.
Murotovich, M. M., & Komiljonovich, N. T. (2022). THE STATE OF HEMODYNAMICS DURING SPINAL AND EPIDURAL ANESTHESIA IN PATIENTS WITH INCREASED BODY MASS INDEX DURING COLOPROCTOLOGICAL SURGERIES (in Uzb). JOURNAL OF BIOMEDICINE AND PRACTICE, 7(2).
Pourmoghaddas, A., & Hekmatnia, A. (2003). The relationship between QTc interval and cardiac autonomic neuropathy in diabetes mellitus. Mol Cell Biochem, 249, 125–128.
Sawicki, P.T., Dähne, R., Bender, R., & Berger, M. (1996). Prolonged QT interval as a predictor of mortality in diabetic nephropathy. Diabetologia, 39, 77–81.
Schwartz, P.J., & Wolf, S. (1978). QT interval prolongation as predictor of sudden death in patients with myocardial infarction. Circulation, 57, 1074–1077.
Smith, L.M., Cozowicz, C., Uda, Y., Memtsoudis, S.G., & Barrington, M.J. (2017). Neuraxial and combined neuraxial/general anesthesia compared to general anesthesia for major truncal and lower limb surgery: A systematic review and meta-analysis. Anesth Analg, 125, 1931–1945.
Wig, J., Bali, I.M., Singh, R.G., Kataria, R.N., & Khattri, H.N. (1979). Prolonged Q-T interval syndrome: Sudden cardiac arrest during anaesthesia. Anaesthesia, 34, 37–40.
Rakhimov M. Nodir, Shakhanova Sh. Shakhnoza Abdurakhmonov A. Jurabek, Talibova A. Nilufar, Sulimova G. Olga. The effectiveness of treatment of ascites due to recurrence of platinum-refractory ovarian cancer using metronomic chemotherapy. Journal of reproductive health and uro-nephrology research 2024 vol 5 issue 1, pp.37-41
Shakhanova Shakhnoza Shavkatovna, Rakhimov Nodir Makhammatkulovich , ., & Murodov Shakhzod Tokhirjon Ugli , . (2024). Aspects of sarcopenia syndrome in oncological practice: diagnosis and treatment. The American Journal of Medical Sciences and Pharmaceutical Research, 6(02), 16–25.
