Postoperative Nausea and Vomiting in Patients with Prolonged QTc

2013 ◽  
Author(s):  
Shilpa Rao ◽  
Jerrold Lerman
Keyword(s):  
Postoperative Nausea ◽  
Qt Interval ◽  
Postoperative Nausea And Vomiting ◽  
Torsades De Pointes ◽  
Nausea And Vomiting ◽  
Receptor Antagonists ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Type 3 ◽  
Potential Interactions

A panoply of pharmacological and nonpharmacological strategies are currently employed to attenuate the risk of postoperative nausea and vomiting (PONV) in children, including 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists. 5-HT3 receptor antagonists can prolong the QT interval, which can be a precursor of torsades de pointes (TdP), particularly in children with congenital or acquired prolonged QT interval. This chapter summarizes the causes of prolonged QT interval, the potential interactions of prolonged QT interval with antiemetics and anesthetics, and strategies to prevent PONV.

Postoperative Nausea and Vomiting in Patients with Prolonged QTc

2018 ◽  
Author(s):  
Adam C. Adler ◽  
Mehernoor Watcha
Keyword(s):  
Postoperative Nausea ◽  
Qt Interval ◽  
Cardiac Electrophysiology ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
General Anesthetic ◽  
Qt Intervals ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
First And Second Generation

Postoperative nausea and vomiting (PONV) is a very common complication after a general anesthetic. In some cases the feeling of nausea has been accredited to being worse than the actual pain. There are a number of medications that can be utilized to combat PONV. Of note, some of these agents can lead to cardiac arrhythmias. It is imperative to know which drugs may predispose patients to arrhythmias such as prolonged QT intervals as well as how to prevent or treat PONV in the patient with prolonged QT interval. This chapter discusses the basics of cardiac electrophysiology regarding the QT interval and the risks to the patient when it becomes prolonged, explains the potential effects of first- and second-generation 5-HT3 receptor antagonists on cardiac repolarization, and reviews currently used antiemetics and anticipated future developments in this field.

scholarly journals Prolonged QTc: "Mind the Gap"

2014 ◽  
Vol 2 (1) ◽  
pp. 44-45
Author(s):  
Ahmad Mursel Anam ◽  
Raihan Rabbani ◽  
Farzana Shumy ◽  
M Mufizul Islam Polash ◽  
M Motiul Islam ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Long Qt Syndrome ◽  
Qt Interval ◽  
Torsades De Pointes ◽  
Junior Doctors ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Qt Syndrome

We report a case of drug induced torsades de pointes, following acquired long QT syndrome. The patient got admitted for shock with acute abdomen. The initial prolonged QT-interval was missed, and a torsadogenic drug was introduced post-operatively. Patient developed torsades de pointes followed by cardiac arrest. She was managed well and discharged without complications. The clinical manifestations of long QT syndromes, syncope or cardiac arrest, result from torsades de pointes. As syncope or cardiac arrest have more common differential diagnoses, even the symptomatic long QT syndrome are commonly missed or misdiagnosed. In acquired long QT syndrome with no prior suggestive feature, it is not impossible to miss the prolonged QT-interval on the ECG tracing. We share our experience so that the clinicians, especially the junior doctors, will be more alert on checking the QT-interval even in asymptomatic patients. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19970 Bangladesh Crit Care J March 2014; 2 (1): 44-45

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