Bolus administration of landiolol, a short-acting, selective beta1-blocker, to treat tachycardia during anesthesia: a dose-dependent study.
OBJECTIVE
The purpose of this study was to clarify the clinical efficacy of landiolol, a selective beta(1)-blocker, in patients developing tachycardia during anesthesia.


METHODS
A prospective, randomized, and placebo-controlled study.


METHODS
A single university hospital.


METHODS
Patients undergoing resection of intracranial or maxillofacial tumors under general anesthesia.


METHODS
Intravenous bolus administration of landiolol.


RESULTS
Patients with heart rates exceeding 90 beats/min for more than 5 minutes received an intravenous bolus dose of landiolol. These patients who developed tachycardia were randomized into 4 groups receiving landiolol in the dose of 0, 0.1, 0.2, or 0.3 mg/kg. Heart rate and blood pressure were recorded before drug injection and 1, 3, 5, 7, 10, 15, 20, 25, and 30 minutes after the injection. Heart rate was significantly reduced with each dose of landiolol compared with the placebo group between 3 and 20 minutes after drug injection. The lowest heart rate was 93 +/- 4, 80 +/- 8, 79 +/- 8, and 77 +/- 6 beats/min (mean +/- standard deviation) in the landiolol 0, 0.1, 0.2, and 0.3 mg/kg groups, respectively. On the other hand, reduction of blood pressure was not as remarkable as that of heart rate. Landiolol, 0.1 and 0.2 mg/kg, did not significantly reduce systolic or diastolic blood pressure during the study period, although significant reduction of blood pressure was observed in the landiolol 0.3-mg/kg group between 5 and 10 minutes after drug injection.


CONCLUSIONS
The results showed that bolus administration of landiolol was effective in the treatment of tachycardia during anesthesia in surgical patients. Landiolol was more efficacious in reducing heart rate than blood pressure.
Harasawa
Rei
R
Department of Anesthesiology, Osaka University Faculty of Medicine, Osaka, Japan.
Hayashi
Yukio
Y
Iwasaki
Mitsuo
M
Kamibayashi
Takahiko
T
Mashimo
Takashi
T
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000704:Analysis of Variance; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D001932:Brain Neoplasms / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D011446:Prospective Studies; D013610:Tachycardia / Q000188:drug therapy* / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea