Mori Kazuhiko, Yamada Kazuhiko, Fukuda Takashi, Mitsui Takashi, Kitamura Takayuki, Yamaguchi Daisuke, Ando Jiro, Wada Ikuo, Nomura Sachiyo, Shimizu Nobuyuki, Seto Yasuyuki
Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan,
Surg Today. 2014 May;44(5):848-54. doi: 10.1007/s00595-013-0615-4. Epub 2013 May 15.
To validate the safety and efficacy of landiolol, a beta1-selective blocker, as a primary care option for postoperative tachycardia after transthoracic esophagectomy.
The subjects were 74 consecutive patients who underwent esophagectomy between May 2008 and December 2009. Patients who developed tachycardia with a heart rate >120 bpm for >5 min were defined as candidates for the use of landiolol. The rate of successful heart control without adverse effects was the primary endpoint. The reduction of the rate pressure product (RPP) and heart rate were used as secondary endpoints.
Thirteen patients (18 %) were treated with landiolol for postoperative tachycardia. No adverse effects were observed. Successful management using landiolol alone was achieved in 10 of the 13 patients (77 %). Of the three patients for whom landiolol treatment was unsuccessful, two were also not successfully managed promptly by other treatments. The heart rate and RPP were reduced by landiolol, with median changes of 38 and 44 %, respectively, without significant negative inotropic effects.
Although our sample size was small, an improved cardiac performance and no severe negative inotropic effects were observed with the use of landiolol. Landiolol could therefore be an efficient and safe choice for the management of postoperative tachycardia after esophagectomy.
验证β1选择性阻滞剂兰地洛尔作为经胸段食管癌切除术后心动过速的一线治疗方案的安全性和有效性。
研究对象为2008年5月至2009年12月期间连续接受食管癌切除术的74例患者。将心率>120次/分且持续>5分钟的心动过速患者定义为使用兰地洛尔的候选对象。主要终点是无不良反应的成功心率控制率。心率压力乘积（RPP）和心率的降低作为次要终点。
13例（18%）患者接受兰地洛尔治疗术后心动过速。未观察到不良反应。13例患者中有10例（77%）仅使用兰地洛尔成功控制。在兰地洛尔治疗失败的3例患者中，2例也未通过其他治疗迅速成功控制。兰地洛尔使心率和RPP降低，中位数变化分别为38%和44%，且无明显负性肌力作用。
尽管我们的样本量较小，但使用兰地洛尔可改善心脏功能且未观察到严重的负性肌力作用。因此，兰地洛尔可能是食管癌切除术后心动过速管理的一种有效且安全的选择。
