Landiolol attenuates tachycardia in response to endotracheal intubation without
affecting blood pressure.
Author(s): Yamazaki A(1), Kinoshita H, Shimogai M, Fujii K, Nakahata K, Hironaka Y, Iranami
H, Hatano Y.
Affiliation(s): Author information:
(1)Department of Anesthesia, Japanese Red Cross Society Wakayama Medical Center,
Wakayama, Japan.
Publication date & source: 2005, Can J Anaesth. , 52(3):254-7
PURPOSE: Beta-adrenergic receptor antagonists (beta-antagonists) have long been
used to control perioperative tachyarrhythmias. The effects of a
beta(1)-antagonist, landiolol, on perioperative hemodynamics are unknown. We
aimed to determine the appropriate dosage of landiolol for the treatment of
hemodynamic changes in response to endotracheal intubation.
METHODS: Sixty-four patients without heart disease or hypertension, were assigned
to receive saline (group C) or landiolol (0.1 or 0.3 mg.kg(-1); groups L1 and
L3). Anesthesia was induced with propofol (2 mg.kg(-1) iv) followed by saline or
landiolol iv. After ventilation with facemask using 2% sevoflurane in 100% oxygen
for 90 sec, endotracheal intubation was performed. After intubation, anesthesia
was maintained using 1% sevoflurane in combination with 50% nitrous oxide. Values
of heart rate and mean arterial blood pressure were recorded before induction to
five minutes after intubation.
RESULTS: In group C, heart rate and mean blood pressure increased simultaneously
after tracheal intubation, compared with baseline values. Heart rate values were
attenuated immediately before as well as after intubation in group L3, compared
with groups C and L1. Heart rate did not increase after tracheal intubation in
group L1, compared with baseline. In contrast, mean arterial blood pressure
values did not differ among groups.
CONCLUSIONS: The newly developed beta(1)-antagonist landiolol (0.1 and 0.3
mg.kg(-1)) may help prevent tachycardia without affecting blood pressure during
the induction of anesthesia.
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