{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:34:37Z","timestamp":1790008477835,"version":"4.0.1"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology"],"published-print":{"date-parts":[[2012,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abnormal cardiac repolarization, indicated by a prolongation of the QT interval, increases the risk for torsades de pointes, a potentially life-threatening arrhythmia. Many perioperatively administered drugs and conditions prolong the QT interval. Despite several reports of perioperative torsades de pointes, systematic evidence regarding perioperative QT interval prolongation is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serial postoperative 12-lead electrocardiograms were obtained from 469 adult patients undergoing major noncardiac surgery under general anesthesia. Heart rate corrected QT-interval duration (Fridericia formula) was the primary outcome. All perioperatively administered drugs were recorded. Emphasis was placed on absolute QTc prolongation greater than 500 ms and relative increases of 30 and 60 ms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the end of surgery, 80% of the patients (345 of 429) experienced a significant QTc interval prolongation (\u0394QTc 23 \u00b1 26 ms (mean and SD), 95% CI 20-25 ms, P less than 0.001). Approximately 51% (219 of 429) had a QTc greater than 440 ms, and 4% (16 of 429) a QTc greater than 500 ms. In 39% (166 of 429), the \u0394QTc was greater than 30 ms, in 8% (34 of 429) &gt;60 ms, and in greater than 0.5% (2 of 429) &gt;100 ms. No changes in \u0394QTc occurred at subsequent time points. One patient developed torsades de pointes with a \u0394QTc: 29 ms (0.4% incidence rate). Several drugs had a large effect on \u0394QTc: isoflurane, methadone, ketorolac, cefoxitin, zosyn, unasyn, epinephrine, ephedrine, and calcium. Postoperative body temperature had a weak negative correlation with \u0394QTc (r = -0.15, P = 0.02); serum magnesium, potassium, and calcium concentrations were not correlated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Postoperative QT-interval prolongation is common. Several perioperatively administered drugs are associated with a substantial QT-interval prolongation. The exact cause and its clinical relevance are, however, unclear. Nevertheless, an association between postoperative QT prolongation and risk for torsades de pointes is likely.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aln.0b013e31825e6eb3","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T21:31:50Z","timestamp":1339536710000},"page":"321-328","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":76,"title":["Postoperative QT Interval Prolongation in Patients Undergoing Noncardiac Surgery under General Anesthesia"],"prefix":"10.1097","volume":"117","author":[{"given":"Peter","family":"Nagele","sequence":"first","affiliation":[{"name":"Assistant Professor of Anesthesiology and Genetics, Department of Anesthesiology, Washington University, St. Louis, Missouri."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swatilika","family":"Pal","sequence":"additional","affiliation":[{"name":"Research Fellow, Department of Anesthesiology, Washington University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Brown","sequence":"additional","affiliation":[{"name":"Research Coordinator, Division of Clinical and Translational Research, Department of Anesthesiology, Washington University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Blood","sequence":"additional","affiliation":[{"name":"Research Nurse Supervisor, Division of Clinical and Translational Research, Department of Anesthesiology, Washington University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u00a0Philipp","family":"Miller","sequence":"additional","affiliation":[{"name":"Professor of Biostatistics, Division of Biostatistics, Washington University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Johnston","sequence":"additional","affiliation":[{"name":"Resident, Department of Anesthesiology, Washington University."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/117\/2\/321\/257701\/0000542-201208000-00022.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.lww.com\/00000542-201208000-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T20:10:15Z","timestamp":1760386215000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000542-201208000-00019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012]]}},"URL":"https:\/\/doi.org\/10.1097\/aln.0b013e31825e6eb3","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.717951615.793456917","asserted-by":"object"}]},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2012,8,1]]}}}