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Anesth Analg 2007;104:124-129
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000249044.40819.e5

ANESTHETIC PHARMACOLOGY

The Hemodynamic Effects of Landiolol, an Ultra-Short-Acting ß1-Selective Blocker, on Endotracheal Intubation in Patients With and Without Hypertension

Soichiro Sugiura, MD, Sumihiko Seki, MD, Kohji Hidaka, MD, PhD, Miharu Masuoka, MD, and Hideaki Tsuchida, MD

From the Department of Anesthesiology and Perioperative Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan.

Address correspondence and reprint requests to S. Sugiura, MD, Department of Anesthesiology and Perioperative Medicine, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa 920-0293, Japan. Address e-mail to s-sugi{at}kanazawa-med.ac.jp.

BACKGROUND: The ultra-short-acting ß1-selective blocker, landiolol, is widely used in Japan. We investigated the effects of landiolol on intubation-induced adrenergic response in 88 patients.

METHODS: General anesthesia was induced and maintained with target-controlled infusion of propofol at an effect–site concentration of 5 µg/mL. Muscle relaxation was obtained with 0.1 mg/kg vecuronium, and endotracheal intubation was performed 4 min after vecuronium injection. We first investigated the optimal time point for landiolol to be administered before intubation in 43 normotensive patients. Then we examined whether landiolol was as effective as fentanyl to prevent tachycardia after intubation in 45 hypertensive patients.

RESULTS: Landiolol at 0.1 mg/kg was most effective against intubation-induced tachycardia when infused 4 min before intubation in normotensive patients. However, 0.2 mg/kg landiolol was necessary to prevent tachycardia after intubation in hypertensive patients. Landiolol had no significant effects on arterial blood pressure or bispectral index at any dose throughout the study period. In contrast, 2 µg/kg fentanyl frequently caused hypotension just before and 5 min after intubation.

CONCLUSION: Low doses of landiolol can effectively prevent tachycardia after intubation without significant effects on arterial blood pressure.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.