RT Journal Article
T1 Cardiac electrophysiological effects of remifentanil: study in a closed-chest porcine model
A1 Zaballos García, Matilde
A1 Jimeno, Concepcion
A1 Almendral Garrote, Jesús
A1 Atienza Fernández, Felipe
A1 Patiño, Daniel
A1 Valdés, Esther
A1 Navia Roque, Juan
A1 Anadón Baselga, María José
AB Background. Remifentanil has been implicated as causing intraoperative bradyarrhythmias, but little information is available regarding its cardiac electrophysiological effects. Thus, we evaluated the cardiac electrophysiological properties before and after remifentanil in a closed- chest porcine model.Methods. Eighteen Landrace–Large pigs were premedicated with ketamine and anaesthetized with propofol (4.5 mg kg21 bolus followed by 13 mg kg21 h21). After instrumentation, an elec- trophysiological evaluation was performed under propofol and repeated after remifentanil (bolus of 1 mg kg21, followed by an infusion of 0.5 mg kg21 min21). We evaluated sinus node function [sinus node recovery time (SNRT) and sinoatrial conduction time (SACT)], atrioven- tricular (AV) nodal function [AH intervals during sinus rhythm (SR) and atrial pacing, Wenckebach cycle length (WCL), and effective refractory periods (ERP)], atrial, His-Purkinje, and ventricular conduction and refractoriness. Significant changes between ‘propofol protocol’ and ‘propofolþremifentanil protocol’ were evaluated.Results. Remifentanil caused a significant increase in sinus cycle length (21%, P1⁄40.001) and a significant prolongation of SNRT (43%, P1⁄40.001), corrected SNRT (136%, P1⁄40.003), SACT (40%, P1⁄40.005), AH interval during SR (17%, P1⁄40.02), AH interval during atrial pacing (25%, P1⁄40.01), and ventricular ERP (12%, P1⁄40.004). There was a tendency towards a prolongation of WCL and AV nodal refractoriness. Similar significant changes were observed in a reference group of seven animals in which sevoflurane was used instead of propofol. No significant changes were observed in atrial parameters, His-Purkinje function, parameters of intraventricu- lar conduction, and QT intervals.Conclusions. Remifentanil depresses sinus node function and most parameters of AV nodal function. This contributes to an explanation for clinical observations of remifentanil-related severe bradyarrhythmias.
PB Elsevier
SN 0007-0912
YR 2009
FD 2009
LK https://hdl.handle.net/20.500.14352/117130
UL https://hdl.handle.net/20.500.14352/117130
LA eng
NO Zaballos M, Jimeno C, Almendral J, Atienza F, Patiño D, Valdes E, Navia J, Anadón MJ. Cardiac electrophysiological effects of remifentanil: study in a closed-chest porcine model. Br J Anaesth. 2009 Aug;103(2):191-8. doi: 10.1093/bja/aep131
DS Docta Complutense
RD 8 abr 2025