title: Adequacy of control of preoperative hypertension can affect landiolol-induced hemodynamic changes in elderly patients during emergence from anesthesia.
abstract: We examined the dose-related effects of landiolol on hemodynamics during emergence from anesthesia of elderly patients with uncontrolled hypertension. Thirty-three normotensive, 34 controlled hypertensive, and 31 uncontrolled hypertensive elderly patients were divided into three groups: control (saline infusion), 0.125 landiolol group, and 0.25 landiolol group. Landiolol or saline infusion was administered at 0.125 (0.125 landiolol group) or 0.25 (0.25 landiolol group) mg/kg/min for 1 min and thereafter decreased to 0.04 or 0.08 mg/kg/min, respectively, until extubation, under regular heart rate and blood pressure monitoring. In normotensive patients, the 0.125 mg/kg/min landiolol infusion was suitable for stabilization of systolic blood pressure and heart rate during tracheal extubation. Controlled hypertensive patients required a 0.25 mg/kg/min landiolol infusion for stabilization of systolic blood pressure and heart rate during tracheal extubation. In uncontrolled hypertensive patients the 0.25 mg/kg/min landiolol infusion could stabilize heart rate, but not systolic blood pressure. In conclusion, the adequacy of preoperative hypertensive control could affect landiolol infusion-induced hemodynamic stability during emergence of elderly patients from anesthesia.
authors.affiliation: Department of Anesthesiology, Gunma University Hospital, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, Japan. kadoi@med.gunma-u.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Shinya
authors.initials: S
authors.lastname: Uchida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D009025:Morpholines / Q000494:pharmacology*; D011300:Preoperative Care; D014508:Urea / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea