Comparison of ventricular repolarization parameters including Tp-e, Tp-e/QTc, JTc and JTd during low-flow and high-flow desflurane anesthesia in gynecologic laparoscopic surgery

Objectives: Low-flow anesthesia (LFA) gained reasonable popularity as it provides many advantages including physiological, ecological, economical issues. Desflurane is a preferable anesthetic in low-flow anesthesia practice however, the relation between QTc, QTd, and QTcd prolongation and management of anesthesia with desflurane has been previously demonstrated. We aimed to compare the effects of low-flow (LFA) and high-flow (HFA) desflurane anesthesia on hemodynamic changes and ventricular repolarization markers in gynecologic laparoscopy. Methods: 58 patients were randomized into group L (LFA, n=30) and group H (HFA, n=28). ECG was recorded before anesthesia and 60th minute of anesthesia in both groups. Results: JTc-0 values were lower than JTc-1 values within both group L and H (p=0.001 for both groups). JTcd-0 and JTd-1 values were lower than JTcd-1 within group H (p=0.042 and 0.002, respectively). QTc-0 values were lower than QTc-1 within both group L and group H (p=0.001 and 0.002, respectively). QTcd-0 values were lower than QTcd-1 within group H (p=0.021). QTd-0 values were lower than QTd-1 within-group H (p=0.026). Tpe-0 and Tpe-1 values were lower in group L (p=0.001 and 0.002 respectively). Also, JTc-0 values were lower than JTc-1 values within both group L and H (p=0.021 and 0.027, respectively). Tpe/QTc-1 ratio was significantly lower in group L (p= 0.010). The difference between Tpe/QTc-0 and Tpe/QTc-1 ratios within group H was significant (p=0.028). Conclusion: Our study showed that there was no significant difference between LFA and HFA in terms of ECG repolarization markers, which may predict the possibility of torsadogenity.