Özet:

In this study, the aim is to compare the effects of ondansetron and metoclopramidine on the QT range. The study included 100 patients from the American Society of Anesthesiologists (ASA I-II) group between the ages of 18 and 65. After the induction of anesthesia was provided with propofol, remifentanil and vecuronium, 4-6% desfluran was applied in O2/dry air. After entubation, one of the random groups is ondansetron 4 mg/2ml (Group-O), the other metoclopramide 10 mg/2ml (Group-M) and control group 2 ml serum physiological (Group-K) iv. was given. Patients were recorded hemodynamic, respiratory parameters and heat values during the course of the operation before induction, after entubation, after the administration of medications. Examples of ECG were taken. In ECG, the QT intervals were measured and the Baszet formula calculated the corrigated values (QTc) according to the heart rate. There were no significant differences in the demographic characteristics between the patient groups and the recorded vital findings during the measurement periods (p>0.05). There was no difference between the groups in the pre-induction basal QTc values (p>0.05). The post-entubation QTc values extended at groups respectively 13.2±11 in Group-K, 20.4±8 in Group-O and 19.0±10 ms in Group-M (p<0,001 according to the pre-entubation values in group comparisons). In all the other interoperative and postoperative measurement periods, the QT range was significantly extended compared to the other two groups in the ondansetron group. QTc values are intraoperative in the control group 30, metoclopramide in the control group 15. As pre-induction values reached in a minute, all intraoperative values in the ondansetron group were higher than pre-induction. In literature, metoclopramide has been to extend the QTc distance in healthy volunteers, but there is no study to investigate this effect in anesthesia. In patients receiving Ondansetron, the QTc values are higher than metoclopramide and remain higher for a longer period of time, and in patients with a long QT range, it has been found that it would be more appropriate to prefer metoclopramide instead of ondansetron in the prevention of vomiting. The Effects of Ondansetron and Metoclopramide Used for Postoperative Nousea and Vomiting Prophylaxis on the QT Interval The aim of this study is to compare the effects of ondansetron and metoclopramide on the QT interval. 100 patients between 18-65 years of age and with ASA physical status I-II were enrolled in this study. General anesthesia was induced with 2-3 mg/kg propofol, 1 μg/kg remifentanil and 0.1 mg/kg vecuronium. Anesthesia wasined with 4% inspired desflurane (in an air - oxygen mixture). The patients were randomly divided into three groups. After intubation, the patients received one of the three study medications. The study medication consisted of either saline (Group-K) or 4 mg ondansetron (Group-O) or 10 mg metoclopramide. Hemodynamic parameters, oxygen saturation and body temperature values were recorded before induction, after intubation and during the surgery after delivery of the study drugs. Synchronous ECG samples were recorded too. The QT intervals were measured and corrected for heart rate (QTc) according to the formula of Basett. The three study groups were similar with regard to their demographic characteristics, the type of surgery, hemodynamic parameters and body temperature. Basal QTc values were also similar in the groups. After intubation QTc prolongation values were 13.2±11 (Group-K), 20.4±8 (Group-O), 19.0±10 (Group-M) ms in groups respectively. After administration the study drugs at intraoperative and postoperative all measurement times, the QT interval was found more prolonged in the ondansetron group then the other two groups. In the control group at 30 min, and in the metoclopramide group at 15 min the QTc values were the same as the values measured before induction. In the ondansetron group all the values measured intraoperatively were higher when compared to the baseline values. Although it is that metoclopramide extends the QT interval in healthy volunteers, there is no study that investigates this effect during surgery. In the patient received ondansetron the QTc values are longer and this prolongation lasted more than in the patient received metoclopramide. These results suggest that, instead of using ondansetron, using metoclopramide for the PONV prophilaxis would be safer on the high risk patients whose QT interval is long.