title: Landiolol infusion during general anesthesia does not prevent postoperative atrial fibrillation in patients undergoing lung resection.
abstract: OBJECTIVE
  We aimed to determine whether intraoperative low-dose infusion of landiolol, an ultra-short-acting beta blocker, can prevent postoperative atrial fibrillation (POAF) after lung resection.
  
  
  METHODS
  A double-blind, randomized, controlled, preliminary study was performed in university academic hospital, single center. Fifty lung surgical patients were key-opened before enrollment of the originally planned 100 patients, who were randomized in a 1:1 ratio in each treatment arm. Landiolol was infused with a dosage of 5 μg/kg/min during general anesthesia in the landiolol group, which was compared with the placebo control group with no landiolol. Atrial fibrillation (AF)-free survival curves were generated by means of Kaplan-Meier estimates and differences in survival were compared with the use of the log-rank test. We examined independent predictors of POAF by the multivariate logistic regression analysis using the perioperative parameters detected with the univariate analysis.
  
  
  RESULTS
  The AF events were recorded for 7 days with Holter monitor in 5 of 25 patients in the landiolol group and 4 of 25 patients in the control group. Kaplan-Meier analysis showed that the landiolol group could not avoid the incidence of POAF in comparison with the placebo saline group (P = 0.806). The multivariate logistic regression analysis for prevalence of POAF identified only one statistically significant predictor: interleukin-6 (IL-6) sampled at 6 h after end of surgery.
  
  
  CONCLUSIONS
  We failed to demonstrate that low-dose infusion of landiolol during general anesthesia could prevent the incidence of AF after lung resection. Only IL-6 sampled at 6 h after end of surgery significantly predicted POAF among pulmonary surgical patients.
authors.affiliation: Department of Anesthesia, Iwate Prefectural Isawa Hospital, 61 Ryugababa, Mizusawa-ku, Oshu, 023-0864, Japan. hirokiaoyama1975@yahoo.co.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Aoyama
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Otsuka
authors.affiliation: Department of Anesthesia, Iwate Prefectural Isawa Hospital, 61 Ryugababa, Mizusawa-ku, Oshu, 023-0864, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Aoyama
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D015996:Survival Rate / Q000639:trends; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea
keywords: Atrial fibrillation; Beta blocker; Landiolol; Lung surgery; Prevention