title: Prophylactic continuous administration of landiolol, a novel β1 blocker, blunts hyperdynamic responses during electroconvulsive therapy without altering seizure activity.
abstract: Abstract Objective. In previous reports, it has been shown that many drugs may act against hyperdynamic responses during electro-convulsive therapy (ECT). The aim of this study was to conduct a randomized, placebo-controlled crossover study to investigate the hemodynamic responses and seizure duration during ECT by continuous administration of two doses of landiolol, a novel short-acting β1-adrenergic blocker, including standard and high-dose. Methods. Thirty-two patients undergoing ECT participated in this study. The control treatment was infusion of saline alone. The standard-dose of landiolol, 0.125 mg/kg per min, was infused over a 1-min period as a standard treatment. The high-dose landiolol treatment was 0.25 mg/kg per min, also infused over a 1-min period. After landiolol treatments, patients received landiolol at 0.04 mg/kg per min. Propofol and succinylcholine was then administered, and electrical stimulation was applied. Results. Both peak heart rate and mean arterial pressure after ECT was lowest with high-dose landiolol treatment. Motor and EEG seizure duration did not differ among the treatments. Conclusion. The results of this study show that high-dose landiolol treatment blunts hyperdynamic responses during ECT. Furthermore, landiolol does not reduce the seizure duration.
authors.affiliation: Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, Tochigi, Japan.
authors.forename: Zen'ichiro
authors.initials: Z
authors.lastname: Wajima
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shiga
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Imanaga
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Inoue
keywords: Electroconvulsive therapy; blood pressure; heart rate; landiolol; seizure duration