Ayşe Yekta Öztürk, Ayfer Keleş, Ahmet Demircan, İsa Kılıçaslan, Fikret Bildik, Mehmet Ali Aslaner, Secdegül Coşkun Yaş, Burhan Çomruk, Burak Şişik, Merve Türker, Aslıhan Küçük Albayrak
{"title":"急诊科常用的静脉注射芬太尼会改变 QTC 值吗？一项前瞻性观察研究。","authors":"Ayşe Yekta Öztürk, Ayfer Keleş, Ahmet Demircan, İsa Kılıçaslan, Fikret Bildik, Mehmet Ali Aslaner, Secdegül Coşkun Yaş, Burhan Çomruk, Burak Şişik, Merve Türker, Aslıhan Küçük Albayrak","doi":"10.1186/s12871-024-02702-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QT<sub>C</sub> values of the patients or being monitored. However, the effect of fentanyl on QT<sub>C</sub>, prolongation or shortening, has not been elucidated. This study aimed to determine the effect of fentanyl on QT<sub>C</sub>.</p><p><strong>Methods: </strong>This is a prospective observational study in the ED of a tertiary hospital on patients who received intravenous fentanyl for procedures other than intubation. ECG was performed before and at 1, 5, 15, 30, and 60 min after the initiation of fentanyl administration, and QT<sub>C</sub> value was calculated. Primary outcomes were QT<sub>C</sub> prolongation, defined as an increase in the QT<sub>C</sub> to ≥ 500 ms or any increase in QT<sub>C</sub> by ≥ 60 ms.</p><p><strong>Results: </strong>The study included 109 patients. Of these, 60 patients were male, and the median age was 40. Compared with the baseline QT<sub>C</sub> value, statistically significant prolongation was detected at the 5th, 15th, 30th, and 60th minutes, with the maximum prolongation at 30 min, and the median was 13.08 ms. Most patients with QT<sub>C</sub> prolongation were female and over 40 years of age. Clinically, none of these patients developed malignant arrhythmias during the 60-minute monitored observation period.</p><p><strong>Conclusion: </strong>Fentanyl prolonged the QT<sub>C</sub> value statistically significantly. Although no patient developed malignant arrhythmia clinically, our results suggest that this QT<sub>C</sub>-prolonging effect should be considered when using fentanyl in patients at risk of torsades.</p>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373170/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does IV fentanyl, frequently used in emergency departments, change QT<sub>C</sub> value? A prospective observational study.\",\"authors\":\"Ayşe Yekta Öztürk, Ayfer Keleş, Ahmet Demircan, İsa Kılıçaslan, Fikret Bildik, Mehmet Ali Aslaner, Secdegül Coşkun Yaş, Burhan Çomruk, Burak Şişik, Merve Türker, Aslıhan Küçük Albayrak\",\"doi\":\"10.1186/s12871-024-02702-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QT<sub>C</sub> values of the patients or being monitored. However, the effect of fentanyl on QT<sub>C</sub>, prolongation or shortening, has not been elucidated. This study aimed to determine the effect of fentanyl on QT<sub>C</sub>.</p><p><strong>Methods: </strong>This is a prospective observational study in the ED of a tertiary hospital on patients who received intravenous fentanyl for procedures other than intubation. ECG was performed before and at 1, 5, 15, 30, and 60 min after the initiation of fentanyl administration, and QT<sub>C</sub> value was calculated. Primary outcomes were QT<sub>C</sub> prolongation, defined as an increase in the QT<sub>C</sub> to ≥ 500 ms or any increase in QT<sub>C</sub> by ≥ 60 ms.</p><p><strong>Results: </strong>The study included 109 patients. Of these, 60 patients were male, and the median age was 40. Compared with the baseline QT<sub>C</sub> value, statistically significant prolongation was detected at the 5th, 15th, 30th, and 60th minutes, with the maximum prolongation at 30 min, and the median was 13.08 ms. Most patients with QT<sub>C</sub> prolongation were female and over 40 years of age. Clinically, none of these patients developed malignant arrhythmias during the 60-minute monitored observation period.</p><p><strong>Conclusion: </strong>Fentanyl prolonged the QT<sub>C</sub> value statistically significantly. Although no patient developed malignant arrhythmia clinically, our results suggest that this QT<sub>C</sub>-prolonging effect should be considered when using fentanyl in patients at risk of torsades.</p>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373170/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12871-024-02702-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12871-024-02702-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
Does IV fentanyl, frequently used in emergency departments, change QTC value? A prospective observational study.
Background: Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QTC values of the patients or being monitored. However, the effect of fentanyl on QTC, prolongation or shortening, has not been elucidated. This study aimed to determine the effect of fentanyl on QTC.
Methods: This is a prospective observational study in the ED of a tertiary hospital on patients who received intravenous fentanyl for procedures other than intubation. ECG was performed before and at 1, 5, 15, 30, and 60 min after the initiation of fentanyl administration, and QTC value was calculated. Primary outcomes were QTC prolongation, defined as an increase in the QTC to ≥ 500 ms or any increase in QTC by ≥ 60 ms.
Results: The study included 109 patients. Of these, 60 patients were male, and the median age was 40. Compared with the baseline QTC value, statistically significant prolongation was detected at the 5th, 15th, 30th, and 60th minutes, with the maximum prolongation at 30 min, and the median was 13.08 ms. Most patients with QTC prolongation were female and over 40 years of age. Clinically, none of these patients developed malignant arrhythmias during the 60-minute monitored observation period.
Conclusion: Fentanyl prolonged the QTC value statistically significantly. Although no patient developed malignant arrhythmia clinically, our results suggest that this QTC-prolonging effect should be considered when using fentanyl in patients at risk of torsades.
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