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Drugs. 2018 Mar;78(3):377-388. doi: 10.1007/s40265-018-0883-9.
Intravenous landiolol [Rapibloc (EU)], an ultra short-acting highly cardioselective β-blocker, is approved in the EU for the rapid short-term control of tachyarrhythmias in the perioperative and intensive care settings. It has long been used in Japan to treat perioperative tachyarrhythmias. The efficacy of landiolol has been demonstrated in a large number of randomized controlled clinical trials. Landiolol significantly reduced heart rate in patients with postoperative or intraoperative supraventricular tachycardia relative to placebo and in those with atrial fibrillation/flutter and left ventricular dysfunction relative to digoxin. It was more effective than diltiazem in converting postoperative atrial fibrillation (POAF) to normal sinus rhythm. Perioperative prophylactic administration of landiolol significantly reduced the incidence of POAF during the first week after cardiac and other surgeries, compared with diltiazem, placebo or no landiolol treatment. Landiolol also attenuated adverse haemodynamic and other responses to invasive procedures such as percutaneous coronary intervention, tracheal intubation, extubation and electroconvulsive therapy. Landiolol was generally well tolerated, with a relatively low risk of hypotension and bradycardia. Landiolol has more favourable pharmacological properties than esmolol, a short-acting β-blocker commonly used for the rapid control of heart rate. Although additional comparative studies are warranted to define the place of landiolol relative to esmolol, current evidence suggest that landiolol is a useful option for the rapid short-term control of tachyarrhythmias. Landiolol offers a simple dosage scheme and is available in two easy-to-use formulations (concentrate and powder).
静脉注射拉贝洛尔[瑞派布洛克（欧盟）]，一种超短效、高心脏选择性β受体阻滞剂，在欧盟被批准用于围手术期和重症监护环境中快速短期控制心动过速。它在日本长期用于治疗围手术期心动过速。拉贝洛尔的疗效已在大量随机对照临床试验中得到证实。与安慰剂相比，拉贝洛尔可显著降低术后或术中室上性心动过速患者的心率，与地高辛相比，可降低心房颤动/扑动和左心室功能障碍患者的心率。与地尔硫卓相比，它在将术后心房颤动（POAF）转为正常窦性心律方面更有效。与地尔硫卓、安慰剂或无拉贝洛尔治疗相比，围手术期预防性给予拉贝洛尔可显著降低心脏和其他手术后第一周 POAF 的发生率。拉贝洛尔还可减轻经皮冠状动脉介入、气管插管、拔管和电惊厥治疗等有创操作的不良血液动力学和其他反应。拉贝洛尔通常具有良好的耐受性，低血压和心动过缓的风险相对较低。与常用于快速控制心率的短效β受体阻滞剂艾司洛尔相比，拉贝洛尔具有更有利的药理学特性。尽管需要进行更多的比较研究来确定拉贝洛尔相对于艾司洛尔的地位，但目前的证据表明，拉贝洛尔是快速短期控制心动过速的有效选择。拉贝洛尔提供了一种简单的剂量方案，并有两种易于使用的制剂（浓缩液和粉剂）。
