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Landiolol attenuates tachycardia in response to endotracheal intubation without affecting blood pressure

[Le landiolol diminue la tachycardie en réponse à l’intubation endotrachéale sans affecter la tension artérielle]

Akinori Yamazaki, MD^*, Hiroyuki Kinoshita, MD PhD^*, Manabu Shimogai, MD^*, Keisuke Fujii, MD^*, Katsutoshi Nakahata, MD^*, Yasuo Hironaka, MD^*, Hiroshi Iranami, MD^* and Yoshio Hatano, MD

^* From the Department of Anesthesia, Japanese Red Cross Society Wakayama Medical Center; and
the Department of Anesthesiology, Wakayama Medical University, Wakayama, Japan.

Address correspondence to: Dr. Hiroyuki Kinoshita, Department of Anesthesiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan. Phone: +81-73-441-0611; Fax: +81-73-448-1032; E-mail: hkinoshi{at}pd5.so-net.ne.jp

Purpose: Beta-adrenergic receptor antagonists (ß-antagonists) have long been used to control perioperative tachyarrhythmias. The effects of a ß₁-antagonist, landiolol, on perioperative hemodynamics are unknown. We aimed to determine the appropriate dosage of landiolol for the treatment of hemodynamic changes in response to endotracheal intubation.

Methods: Sixty-four patients without heart disease or hypertension, were assigned to receive saline (group C) or landiolol (0.1 or 0.3 mg·kg^–1; groups L1 and L3). Anesthesia was induced with propofol (2 mg·kg^–1 iv) followed by saline or landiolol iv. After ventilation with facemask using 2% sevoflurane in 100% oxygen for 90 sec, endotracheal intubation was performed. After intubation, anesthesia was maintained using 1% sevoflurane in combination with 50% nitrous oxide. Values of heart rate and mean arterial blood pressure were recorded before induction to five minutes after intubation.

Results: In group C, heart rate and mean blood pressure increased simultaneously after tracheal intubation, compared with baseline values. Heart rate values were attenuated immediately before as well as after intubation in group L3, compared with groups C and L1. Heart rate did not increase after tracheal intubation in group L1, compared with baseline. In contrast, mean arterial blood pressure values did not differ among groups.

Conclusions: The newly developed ß₁-antagonist landiolol (0.1 and 0.3 mg·kg^–1) may help prevent tachycardia without affecting blood pressure during the induction of anesthesia.

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