Department of Anesthesiology, Dokkyo Medical University, School of Medicine, Tochigi, Japan.
J Clin Anesth. 2009 Dec;21(8):555-61. doi: 10.1016/j.jclinane.2008.12.027.
To examine the effects of landiolol on the QT interval, rate-corrected QT (QTc) interval, QT dispersion (QTD), and rate-corrected QTD (QTcD) during tracheal intubation using computerized measurement.
Randomized, double-blinded study.
Dokkyo Medical University Hospital operating room.
30 ASA physical status I patients scheduled for elective surgery.
Patients were randomized to receive either normal saline (saline group) or landiolol (landiolol group; one-min loading infusion of 0.125 mg/kg followed by 0.04 mg/kg/min infusion). Immediately after the start of administration of saline or landiolol, anesthesia was induced with intravenous (IV) fentanyl two microg/kg, propofol 1.5 mg/kg, and vecuronium 0.1 mg/kg. Six minutes after administration of saline or landiolol, tracheal intubation was performed within 20 seconds.
Mean arterial pressure (MAP), RR interval, QT interval, QTc interval, QTD, and QTcD were consecutively recorded during the induction.
There was no significant difference in MAP between groups during the study. RR interval in the landiolol group was significantly longer than in the saline group from two minutes after the start of the landiolol infusion to the end of the study. The QT interval in the landiolol group was significantly shorter than in the saline group from start of the infusion to 4 minutes after tracheal intubation. The QTc interval, QTD, and QTcD in the landiolol group were significantly shorter than those in the saline group from immediately after tracheal intubation to the end of study.
A bolus of landiolol 0.125 mg/kg followed by an infusion of landiolol 0.04 mg/kg/min may reduce the risk of cardiac arrhythmias during induction of anesthesia.
使用计算机测量研究气管插管时拉地洛尔对 QT 间期、校正 QT 间期(QTc)、QT 离散度(QTD)和校正 QTD(QTcD)的影响。
随机、双盲研究。
日本独协医科大学医院手术室。
30 名 ASA 身体状况 I 级择期手术患者。
患者随机分为生理盐水组(盐水组)或拉地洛尔组(拉地洛尔组;静脉注射 0.125mg/kg 负荷量,然后以 0.04mg/kg/min 的速度输注)。在开始给予生理盐水或拉地洛尔后立即静脉注射芬太尼 2μg/kg、丙泊酚 1.5mg/kg 和维库溴铵 0.1mg/kg 进行麻醉。在给予生理盐水或拉地洛尔后 6 分钟内,在 20 秒内进行气管插管。
在诱导过程中连续记录平均动脉压(MAP)、RR 间隔、QT 间期、QTc 间期、QTD 和 QTcD。
研究过程中两组之间的 MAP 无显著差异。从拉地洛尔输注开始后两分钟到研究结束,拉地洛尔组的 RR 间隔明显长于盐水组。拉地洛尔组的 QT 间期明显短于盐水组,从开始输注到气管插管后 4 分钟。拉地洛尔组的 QTc 间期、QTD 和 QTcD 从气管插管后立即到研究结束均明显短于盐水组。
静脉注射 0.125mg/kg 拉地洛尔负荷量,然后以 0.04mg/kg/min 的速度输注拉地洛尔,可能会降低麻醉诱导期间心律失常的风险。