Department of Anesthesia and Intensive Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Department of Anesthesia and Intensive Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
J Clin Anesth. 2017 May;38:111-116. doi: 10.1016/j.jclinane.2017.01.036. Epub 2017 Feb 1.
To determine whether perioperative landiolol administration suppresses postoperative atrial fibrillation (AF) and the plasma cytokines elevation in patients undergoing esophageal cancer surgery.
A prospective, randomized controlled trial.
Akita University Hospital, Akita, Japan, from April 2012 to January 2015.
Forty American Society of Anesthesiologists grade I-II patients undergoing elective esophagectomy.
Patients were randomly divided into two groups, landiolol group (landiolol: 5μg/kg/min) and control group (the same volume of covered saline). Landiolol or saline was infused continuously from the induction of anesthesia until next morning.
We examined the new onset of AF and sinus tachycardia, and measured plasma concentrations of cytokines (IL-1β, IL-6, IL-8, IL-10, and TNF-α) just before surgery, at the end of surgery, the next day, and 2days after surgery. Data (mean±SD) were analyzed using two-way ANOVA followed by the Bonferroni"s test for post hoc comparison; a P<0.05 was considered statistically significant.
Demographic data were similar between the landiolol and the control groups. The incidence of AF was significantly lower in the landiolol group (1/19=5.3%) compared with the control group (7/20=35%) as well as sinus tachycardia (landiolol group, 0/19=0% vs. control group, 5/20=25%). Plasma IL-6 level at the end of surgery was significantly lower in the landiolol group compared with the control group, but the other plasma cytokines levels were similar between the two groups during the entire study period.
Perioperative landiolol administration suppressed the incidence of new-onset of AF as well as sinus tachycardia, and the plasma IL-6 elevation in patients undergoing esophageal cancer surgery.
确定围手术期兰地洛尔给药是否抑制食管癌手术患者术后心房颤动（AF）和血浆细胞因子升高。
前瞻性、随机对照试验。
日本秋田大学医院，2012 年 4 月至 2015 年 1 月。
40 名美国麻醉医师学会分级 I-II 级择期行食管癌切除术的患者。
患者随机分为两组，兰地洛尔组（兰地洛尔：5μg/kg/min）和对照组（等量覆盖生理盐水）。从麻醉诱导开始至次日早晨，持续输注兰地洛尔或生理盐水。
我们检查了新发 AF 和窦性心动过速，并在手术前、手术结束时、次日和术后 2 天测量了细胞因子（IL-1β、IL-6、IL-8、IL-10 和 TNF-α）的血浆浓度。数据（均数±标准差）采用双因素方差分析，然后用 Bonferroni 检验进行事后比较；P<0.05 认为有统计学意义。
兰地洛尔组和对照组的人口统计学数据相似。兰地洛尔组 AF 的发生率（1/19=5.3%）明显低于对照组（7/20=35%）和窦性心动过速（兰地洛尔组，0/19=0% vs. 对照组，5/20=25%）。与对照组相比，兰地洛尔组手术结束时血浆 IL-6 水平明显降低，但在整个研究期间，两组的其他血浆细胞因子水平相似。
围手术期兰地洛尔给药可抑制食管癌手术患者新发 AF 及窦性心动过速的发生，并抑制血浆 IL-6 的升高。
