Department of Anesthesiology, Gunma University Hospital, School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
J Anesth. 2010 Apr;24(2):272-6. doi: 10.1007/s00540-010-0870-0. Epub 2010 Feb 6.
The purpose of this study was to examine the effects of landiolol on left ventricular (LV) systolic function, using transthoracic echocardiography, during electroconvulsive therapy (ECT). Fourteen patients undergoing ECT were studied. Bilateral ECT was performed after administration of thiopentone (2 mg/kg), succinylcholine (1 mg/kg), and initiation of assisted mask ventilation with 100% oxygen. Patients received a bolus injection of landiolol (0.125 mg/kg) or saline immediately after anesthetic induction and prior to electrical shock. LV systolic function was examined by transthoracic echocardiography prior to anesthetic induction, throughout the ECT procedure, and for 10 min after the seizure. Electrical shock resulted in a significant decrease in fractional area change (FAC) when compared with the awake condition in the control group [FAC when awake: 48 +/- 3%; 1 min after ECT: 38 +/- 4%; 2 min after ECT: 36 +/- 4%; 3 min after ECT: 40 +/- 3%*; mean +/- standard deviation, *p < 0.05 compared with awake]. Landiolol infusion stabilized systemic hemodynamics and LV systolic function. The study demonstrated that landiolol is a suitable agent to minimize hemodynamic changes and transthoracic echocardiographic variability after ECT.
本研究旨在通过经胸超声心动图观察拉地洛尔对电抽搐治疗（ECT）过程中左心室（LV）收缩功能的影响。研究了 14 名接受 ECT 的患者。在给予硫喷妥钠（2mg/kg）、琥珀胆碱（1mg/kg）和 100%氧气辅助面罩通气后，行双侧 ECT。麻醉诱导后即刻和电刺激前，患者给予拉地洛尔（0.125mg/kg）或生理盐水推注。在麻醉诱导前、ECT 过程中和抽搐后 10min，通过经胸超声心动图检查 LV 收缩功能。与对照组清醒状态相比，电刺激导致分数面积变化（FAC）显著降低[对照组清醒时 FAC：48±3%；ECT 后 1min：38±4%；ECT 后 2min：36±4%；ECT 后 3min：40±3%*；平均值±标准差，*p<0.05 与清醒状态比较]。拉地洛尔输注稳定了全身血流动力学和 LV 收缩功能。该研究表明，拉地洛尔是一种合适的药物，可最大限度地减少 ECT 后血流动力学变化和经胸超声心动图的变异性。
