KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

eISSN: 2757-9336
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
The relationship between QT interval and pain severity in trauma patients in the emergency department
Abstract
Aims: Cardiac depolarization occurs in patients experiencing pain from acute traumas, and changes in QT interval could indicate the state of ventricular depolarization. Thus, we aimed to determine the relationship between pain severity and QT interval in patients experiencing acute trauma.
Methods: Seventy patients, who were conscutively- admitted to the Emergency Department due to moderate or severe trauma (study group), and sixty healthy individuals (control group) were included in this study. The QT interval was calculated for each group before and after analgesia and visual analog scale pain levels were recorded. Statistical analyses were performed using SPSS for Windows software (ver. 21.0; SPSS Inc., Chicago, IL, USA). Data are presented as medians±interquartile range (IQR). Statistical significance was determined using Mann-Whitney U, Wilcoxon, and chi-square tests, with a p-value <0.05 considered significant.
Results: The mean age of patients with trauma and control patients was 31.50±25 years and 35.00±20 years, respectively. Among trauma patients, QT, RR and corrected QT (QTc) intervals were significantly different before and after analgesia (P<0.001). Similarly, the average pre-analgesia QT, RR and QTc values also differed between pre- and post-analgesia trauma patients (p=0.007, p<0.001, and p<0.001, respectively). However, no differences in QT values were observed before and after analgesia between patients experiencing moderate versus severe pain (p>0.05).
Conclusion: In trauma patients, acute pain prolonged the QT interval, which reverted to normal following the administration of nonsteroidal anti-inflammatory drugs. However, additional comparative studies on this topic are required.

Keywords : Emergency service, pain, trauma, electrocardiogram, QT interval

Download Article


1. Milojevic K. G, Centineau J. P, Ruiz R, Coudert B, Bataille S, Boutot F, et al. Can severe acute pain, escope visual analog scale screening in the ED?. The American Journal of Emergency Medicine; 2004; 22(3): 238-41.
2. Erdine S. AğrıN&ouml;rofizyolojisi. HipokratDergisi 1996; 9-12.
3. Svenson J, Lacharite D. G&ouml;ğ&uuml;stravması. Stone CK, et al. G&uuml;ncel, AcilTanıveTedavi. 5th Ed. Adana: Nobel Matbaa, 2006: 454-466.
4. Blair E, Topuzlu C, Davis JH. Delayed or missed diagnosis in blunt chest trauma. J trauma, 1971;1: 129-45. 5thEd Adana: Nobel Matbaa, 2006: 454-66.
5. Desmond G. Julian, J. Campbell Cowan, James M. McLenachan. Cardiology. The electrical activity of the heart: the electrocardiaogram. W.B.Saunders 2000;9-31.
6. Bazett HC. An analysis of the time relations of electrocardiograms. Heart 1920; 7:353-70.
7. Masaru Suzuki, Katsunori Aoki, Kazuhiko Sekine, Naoki Aikawa. Correlation between QT dispersion and burn severity. Burns 28 (2002) 481-5
8. Koturoglu G, Kurugol Z, Levent E. QT prolongation and min&ouml;r head trauma: a report of two cases. Minerva Pediatr. 2006 Dec;58(6):575-7.
9. &Ouml;zg&uuml;rKarcıoğlu, Acilkoşullardaağrıy&ouml;netimiveanaljeziuygulamaları. T&uuml;rkAileHekDerg 2010; 14(2): 53-63
10. İmren A.H, Turan O. Plazmanınenzimleri. KlinikTanıdaLaboratuar. Beta Basım Yay İstanbul, 1985:225-7.
11. Ufuk&Ccedil;obanoğlu. G&ouml;ğ&uuml;sTravmalı 70 OlgudaKardiyolojikDeğişikliklerinincelenmesi. ToraksDergisi 2007; 8(2): 59-68
12. Karakuş A, Keke&ccedil; Z, Ak&ccedil;an R and Seydaoğlu G. The relationship of trauma severity and mortality with cardiac enzymes and cytokines at multiple trauma patients. Ulus TravmaAcilCerrahiDerg: 2012 Jul; 18 (4): 289-95.
13. Yang ZF, Wang HW, Zheng YQ, Zhang Y, Liu YM, Li CZ. Possible arrhythmiogenic mechanism produced by ibuprofen. Acta Pharmacol Sin. 2008 Apr; 29(4):421-9.
14. Krist&oacute;f A, Husti Z, Koncz I, Kohajda Z, Sz&eacute;l T, Juh&aacute;sz V, et al. Diclofenac prolongs repolarization in ventricular muscle with impaired repolarization reserve. PLoS One. 2012; 7 (12): 532-55
15. &Ouml;zdemir D, &Ouml;zdemir N, &Uuml;nal N, Tektaş Ş. QTc dispersion in children withsevere head trauma. Pediatr Emerg Care 2005; 21: 10: 658-61.
16. Wittebole X, Hantson P, Laterre PF, et al. Electrocardiographic changesafter head trauma. J Electrocardiol 2005; 38: 77-81.
Article available in :
Volume 1, Issue 3, 2021
Page : 75-78
https://doi.org/10.51271/KMJ-0018
Article Information
Received : 08 May 2021
Accepted : 27 Ağu 2021
Published : 29 Ara 2022
Corresponding Author :

Mehmet Emin Layık: Van Yüzüncü Yıl University, Department of Family Medicine, Van, Turkey

[email protected]
Citation : Nimetoğlu MS, Gökdemir MT, İz M, Layık ME. The relationship between qt interval and pain severity in trauma patients in the emergency department. Kastamonu Med J. 2021;1(3): 75-78.

Read: 8
Cited: 0
Download : 75
_Footer