Efficacy of landiolol in attenuating hemodynamic responses to local epinephrine infiltration in patients undergoing vaginal total hysterectomy

Hirota, Kazuyoshi; Baba, Sachiko; Fukushi, S; Muraoka, Masahiro; Matsuki, Akitomo

doi:10.1007/s00540-004-0281-1

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…Therefore, it is less likely to cause hypotension and can control heart rate while minimizing the effect on blood pressure in patients with anaphylactic shock. Since landiolol can suppress the hemodynamic effects of adrenaline, [ 17 , 18 ] it was administered in combination with the careful use of adrenaline to reduce myocardial oxygen consumption and maintain the myocardial oxygen supply–demand balance by suppressing tachycardia.…”

Section: Discussionmentioning

confidence: 99%

Anaphylactic shock in a patient with severe aortic stenosis treated with adrenaline and landiolol for circulatory management

et al. 2021

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Rationale: We present the first case of a patient with severe aortic stenosis who developed anaphylactic shock and was successfully treated with adrenaline and landiolol, a highly selective β1-receptor blocker, to prevent disruption of the myocardial oxygen supply–demand balance caused by tachycardia. Patient concerns: An 86-year-old woman was scheduled for simultaneous anterior–posterior fixation for a burst fracture of the 12th thoracic vertebra; 200 mg sugammadex, a neuromuscular blocking agent antagonist, was administered postoperatively, and she was extubated without complications. However, 6 min after extubation, her blood pressure decreased abruptly to 55/29 mm Hg, and her heart rate increased to 78 bpm. Then, we intervened with fluid loading, an increased dose of noradrenaline, and phenylephrine administration. However, her blood pressure did not increase. Diagnoses: A general observation revealed urticaria on the lower leg; thus, we suspected anaphylactic shock due to sugammadex administration. Interventions: We carefully administered 2 doses of 0.05 mg adrenaline and simultaneously administered landiolol at 60 μg/kg/min to suppress adrenaline-induced tachycardia. Adrenaline administration resulted in a rapid increase in blood pressure to 103/66 mm Hg and a maximum heart rate of 100 bpm, suppressing excessive tachycardia. Outcomes: The patient's general condition was stable after the intervention, and circulatory agonists could be discontinued the following day. She was discharged from the intensive care unit on the fourth postoperative day. Lessons: Landiolol may help control the heart rate of patients with aortic stenosis and anaphylactic shock. The combined use of landiolol and adrenaline may improve patient outcomes; however, their efficacy and risks must be evaluated by studying additional cases.

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Section: Discussionmentioning

confidence: 99%

Anaphylactic shock in a patient with severe aortic stenosis treated with adrenaline and landiolol for circulatory management

et al. 2021

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“…Landiolol is a short-acting b1-selective blocker characterized by a short half-life (4 min) and good stability in continuous administration [4]. The drug has been used for treatment of perioperative tachyarrhythmia in Japan [5][6][7][8], and successful control of heart rate and conversion to sinus rhythm in patients with atrial fibrillation has also been achieved with landiolol [8]. A similar clinical course occurred in our patient with atrial flutter, with sinus rhythm obtained when arrhythmia was controlled by administration of landiolol.…”

Section: Discussionmentioning

confidence: 99%

Conversion of atrial flutter to sinus rhythm during landiolol infusion

et al. 2009

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A 73-year-old male patient with a past history of hypertension and atrial premature contraction underwent endoscopic restoration of the left bubonocele. Sinus rhythm was confirmed by preoperative electrocardiography, but paroxysmal atrial flutter developed when abdominoscopy was started. Continuous administration of landiolol hydrochloride at a dose of 0.005 mg kg(-1) min(-1) after a loading dose of 0.04 mg kg(-1) min(-1) for 1 min resulted in control of heart rate without a decrease in blood pressure. Atrial flutter was converted to sinus rhythm 3 min after the start of administration. Landiolol hydrochloride was administered continuously until the morning of the following day and sinus rhythm was maintained postoperatively.

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“…Landiolol, an ultra-short-acting ␤ 1 -selective adrenoceptor antagonist, is now being widely used in Japan (6,7). It has a shorter plasma half-life of approximately 4 min and a higher cardioselectivity, with a potency ratio (␤ 1 /␤ 2 ) of 255, as compared with 9 min and 33, respectively, for esmolol (8 -10).…”

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confidence: 99%

The Hemodynamic Effects of Landiolol, an Ultra-Short-Acting ??1-Selective Blocker, on Endotracheal Intubation in Patients With and Without Hypertension

Sugiura

Seki

Hidaka

et al. 2007

Anesthesia & Analgesia

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Efficacy of landiolol in attenuating hemodynamic responses to local epinephrine infiltration in patients undergoing vaginal total hysterectomy

Abstract: The present study suggests that landiolol 10 mg may be a more suitable dose than landiolol 5 mg to antagonize hyperdynamic states induced by local administration of epinephrine.

Cited by 11 publications

References 9 publications

Anaphylactic shock in a patient with severe aortic stenosis treated with adrenaline and landiolol for circulatory management

Anaphylactic shock in a patient with severe aortic stenosis treated with adrenaline and landiolol for circulatory management

Conversion of atrial flutter to sinus rhythm during landiolol infusion

The Hemodynamic Effects of Landiolol, an Ultra-Short-Acting ??1-Selective Blocker, on Endotracheal Intubation in Patients With and Without Hypertension

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