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Droperidol transiently prolongs the QT interval in children undergoing single ventricle palliation. Pediatr Cardiol 2015 Jan;36(1):196-204

Date

08/05/2014

Pubmed ID

25087057

DOI

10.1007/s00246-014-0985-4

Scopus ID

2-s2.0-84937210854   2 Citations

Abstract

Historically, droperidol was commonly used for postoperative sedation of critically ill children. A FDA black box warning regarding its arrhythmogenic potential greatly reduced its use. We hypothesized that administration of neuroleptic dose droperidol during volatile anesthesia would transiently prolong the corrected QT interval (QTc) in patients undergoing single ventricle palliation. As part of a prospective study in children undergoing stage 2 or 3 single ventricle palliation, we recorded electrocardiograms preoperatively, after induction of volatile anesthesia, immediately after completion of 30 min intravenous infusion of 75 mcg/kg droperidol, and shortly after arrival in the cardiac intensive care unit. Mean absolute QT intervals and heart rate data were analyzed in a blinded fashion and the longest QT interval was determined. QT intervals were corrected for heart rate (QTc) with the Bazett and Friderici formulae. Any perioperative arrhythmias were recorded. Complete data were available for 62 patients. Volatile anesthesia was associated with significant prolongation of the QTc interval. Administration of droperidol after cardiopulmonary bypass was associated with further significant QTc prolongation. All QTc changes were transient and the postoperative QTc, while still prolonged relative to baseline, was significantly shorter than the QTc immediately postdroperidol. No episodes of Torsades de Pointes (TdP) or ventricular arrhythmias were observed. The administration of a neuroleptic dose of droperidol during volatile anesthesia in patients undergoing single ventricle palliation was associated with a significant prolongation of QTc, which was transient and did not result in TdP or other ventricular arrhythmias in our study population.

Author List

Scott JP, Stuth EA, Stucke AG, Cava JR, Berens RJ

Authors

Richard J. Berens MD Professor in the Anesthesiology department at Medical College of Wisconsin
Joseph R. Cava MD, PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
John P. Scott MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Astrid G. Stucke MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Eckehard A. Stuth MD Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adjuvants, Anesthesia
Child
Child, Preschool
Droperidol
Electrocardiography
Female
Heart Defects, Congenital
Heart Ventricles
Humans
Infant
Long QT Syndrome
Male
Palliative Care
Risk Factors
jenkins-FCD Prod-411 e00897e83867fcfa48419861683711f8d99adb75