Effects of landiolol on hemodynamic response and seizure duration during electroconvulsive therapy.
OBJECTIVE
This study was done to evaluate the effect of landiolol, an ultra-short-acting beta-blocker, on the hemodynamic response and the duration of seizure activity during electroconvulsive therapy (ECT).


METHODS
We designed a prospective, randomized, double-blinded, placebo-controlled, crossover study. Fourteen psychiatric patients participated. Landiolol (0.1 mg x kg(-1) or 0.2 mg x kg(-1)) or saline (placebo) was administered IV 1 min before the induction of anesthesia. Unconsciousness was induced with propofol 1.0 mg x kg(-1) IV, and muscle paralysis was produced with succinylcholine 0.6 mg x kg(-1) IV. Subsequently, electrical stimulus was administered to elicit a seizure, and the duration of the motor seizure activity was noted.


RESULTS
The heart rate (HR) and rate-pressure product (RPP) before ECT were significantly decreased in the 0.2 mg x kg(-1) landiolol group compared with these parameters in the placebo and 0.1 mg x kg(-1) landiolol groups. Both the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses significantly attenuated the degree of tachycardia and RPP after ECT in comparison with the placebo group. Pretreatment with 0.2 mg x kg(-1) landiolol resulted in a significantly shorter duration of motor seizure than that in the placebo group (21 +/- 13 s vs 27 +/- 12 s).


CONCLUSIONS
As the landiolol dose of 0.2 mg x kg(-1) caused shorter seizure duration, and because the hemodynamic effects after ECT of the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses were similar, it was concluded that a 0.1 mg x kg(-1) landiolol bolus was the appropriate dose pretreatment before ECT.
Nomoto
Koichi
K
Department of Anesthesiology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Yokohama 224-8503, Japan.
Suzuki
Takashi
T
Serada
Kazuyuki
K
Oe
Katsunori
K
Yoshida
Tatsuya
T
Yamada
Sayoko
S
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000494:pharmacology*; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy*; D012965:Sodium Chloride / Q000008:administration & dosage; D013390:Succinylcholine / Q000008:administration & dosage; D013997:Time Factors; D014508:Urea / Q000031:analogs & derivatives* / Q000494:pharmacology
D000319:Adrenergic beta-Antagonists; D018686:Anesthetics, Intravenous; D009025:Morpholines; D009467:Neuromuscular Depolarizing Agents; D012965:Sodium Chloride; C077049:landiolol; D014508:Urea; D013390:Succinylcholine; D015742:Propofol