Effects of landiolol on hemodynamic response and seizure duration during electroconvulsive therapy.

Abstract

PURPOSE:

This study was done to evaluate the effect of landiolol, an ultra-short-acting beta-blocker, on the hemodynamic response and the duration of seizure activity during electroconvulsive therapy (ECT).

METHODS:

We designed a prospective, randomized, double-blinded, placebo-controlled, crossover study. Fourteen psychiatric patients participated. Landiolol (0.1 mg x kg(-1) or 0.2 mg x kg(-1)) or saline (placebo) was administered IV 1 min before the induction of anesthesia. Unconsciousness was induced with propofol 1.0 mg x kg(-1) IV, and muscle paralysis was produced with succinylcholine 0.6 mg x kg(-1) IV. Subsequently, electrical stimulus was administered to elicit a seizure, and the duration of the motor seizure activity was noted.

RESULTS:

The heart rate (HR) and rate-pressure product (RPP) before ECT were significantly decreased in the 0.2 mg x kg(-1) landiolol group compared with these parameters in the placebo and 0.1 mg x kg(-1) landiolol groups. Both the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses significantly attenuated the degree of tachycardia and RPP after ECT in comparison with the placebo group. Pretreatment with 0.2 mg x kg(-1) landiolol resulted in a significantly shorter duration of motor seizure than that in the placebo group (21 +/- 13 s vs 27 +/- 12 s).

CONCLUSION:

As the landiolol dose of 0.2 mg x kg(-1) caused shorter seizure duration, and because the hemodynamic effects after ECT of the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses were similar, it was concluded that a 0.1 mg x kg(-1) landiolol bolus was the appropriate dose pretreatment before ECT.

• Authors: Koichi Nomoto, Takashi Suzuki, Kazuyuki Serada, Katsunori Oe, Tatsuya Yoshida, Sayoko Yamada
• Journal: Journal of anesthesia (J Anesth) Vol. 20 Issue 3 Pg. 183-7 ( 2006) ISSN: 0913-8668 [Print] Japan
• PMID: 16897237 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic beta-Antagonists
• Anesthetics, Intravenous
• Morpholines
• Neuromuscular Depolarizing Agents
• Sodium Chloride
• landiolol
• Urea
• Succinylcholine
• Propofol

Topics

• Adrenergic beta-Antagonists (pharmacology)
• Aged
• Anesthetics, Intravenous (administration & dosage)
• Blood Pressure (drug effects)
• Cross-Over Studies
• Double-Blind Method
• Electroconvulsive Therapy (adverse effects)
• Female
• Heart Rate (drug effects)
• Humans
• Male
• Middle Aged
• Morpholines (pharmacology)
• Neuromuscular Depolarizing Agents (administration & dosage)
• Propofol (administration & dosage)
• Prospective Studies
• Seizures (drug therapy)
• Sodium Chloride (administration & dosage)
• Succinylcholine (administration & dosage)
• Time Factors
• Urea (analogs & derivatives, pharmacology)