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[Landiolol infusion attenuates increase in heart rate, but does not prevent increase in blood pressure in response to emergence from anesthesia and tracheal extubation].

Tatsuo Horiuchi, Shinya Uchida, Yuji Kadoi, Shigeru Saito, Masayuki Sasaki, Daisuke Yoshikawa, Tateo Sugaya, Hitoshi Shimada, Noboru Maruyama, Jun Satoh, Takeshi Nara, Kenichiro Takahashi

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Abstract

BACKGROUND: Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. The purpose of this study was to examine the effects of different doses of landiolol on hemodynamics during emergence from anesthesia. METHODS: All patients undergoing general anesthesia were enrolled in this study. Immediately after the end of the surgery, all anesthetics were discontinued. Thereafter, during emergence from anesthesia, all patients were ventilated with 100% oxygen and landiolol infusion was started in all but the control group patients. In the normal dose group, landiolol infusion was started at a rate of 0.125 mg x kg(-1) x min(-1) for 1 min, decreasing it to 0.04 mg x kg(-1) x min(-1) until the time of extubation. In the low dose group, landiolol infusion was given at a rate of 0.06 mg x kg(-1) x min(-1) for 1 min and then continuously infused at the rate of 0.02 mg x kg(-1) x min(-1) until extubation. RESULTS: Systolic and diastolic pressure increased during the emergence period in all 3 groups, there being no significant differences in systolic and diastolic pressure between the 3 groups during the observation period. Heart rate increased during the emergence period in the control group. In contrast, heart rate in both normal and low dose groups did not increase during the observation period. CONCLUSIONS: Landiolol could prevent the increase in heart rate but not blood pressure during emergence from anesthesia. Effects on the changes in heart rate between 0.125 and 0.06 landiolol groups were not significantly different.

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What this paper is about

BACKGROUND: Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. The purpose of this study was to examine the effects of different doses of landiolol on hemodynamics during emergence from anesthesia. METHODS: All patients undergoing general anesthesia were enrolled in this study. Immediately after the end of the surgery, all anesthetics were discontinued. Thereafter, during emergence from anesthesia, all patients were ventilated with 100% oxygen and landiolol infusion was started in all but the control group patients. In the normal dose group, landiolol infusion was started at a rate of 0.125 mg x kg(-1) x min(-1) for 1 min, decreasing it to 0.04 mg x kg(-1) x min(-1) until the time of extubation. In the low dose group, landiolol infusion was given at a rate of 0.06 mg x kg(-1) x min(-1) for 1 min and then continuously infused at the rate of 0.02 mg x kg(-1) x min(-1) until extubation. RESULTS: Systolic and diastolic pressure increased during the emergence period in all 3 groups, there being no significant differences in systolic and diastolic pressure between the 3 groups during the observation period. Heart rate increased during the emergence period in the control group. In contrast, heart rate in both normal and low dose groups did not increase during the observation period. CONCLUSIONS: Landiolol could prevent the increase in heart rate but not blood pressure during emergence from anesthesia. Effects on the changes in heart rate between 0.125 and 0.06 landiolol groups were not significantly different.

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Available abstract

BACKGROUND: Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. The purpose of this study was to examine the effects of different doses of landiolol on hemodynamics during emergence from anesthesia. METHODS: All patients undergoing general anesthesia were enrolled in this study. Immediately after the end of the surgery, all anesthetics were discontinued. Thereafter, during emergence from anesthesia, all patients were ventilated with 100% oxygen and landiolol infusion was started in all but the control group patients. In the normal dose group, landiolol infusion was started at a rate of 0.125 mg x kg(-1) x min(-1) for 1 min, decreasing it to 0.04 mg x kg(-1) x min(-1) until the time of extubation. In the low dose group, landiolol infusion was given at a rate of 0.06 mg x kg(-1) x min(-1) for 1 min and then continuously infused at the rate of 0.02 mg x kg(-1) x min(-1) until extubation. RESULTS: Systolic and diastolic pressure increased during the emergence period in all 3 groups, there being no significant differences in systolic and diastolic pressure between the 3 groups during the observation period. Heart rate increased during the emergence period in the control group. In contrast, heart rate in both normal and low dose groups did not increase during the observation period. CONCLUSIONS: Landiolol could prevent the increase in heart rate but not blood pressure during emergence from anesthesia. Effects on the changes in heart rate between 0.125 and 0.06 landiolol groups were not significantly different.

Key concepts: Anesthesia, Heart rate, Blood pressure, Medicine, Hemodynamics, Internal medicine

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[Landiolol infusion attenuates increase in heart rate, but does not prevent increase in blood pressure in response to emergence from anesthesia and tracheal extubation]. — Research Paper | ScholarLens