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Does intravenous landiolol, a β1-adrenergic blocker, affect stroke volume variation?

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Abstract

Purpose

There are no reports about the effect of bradycardia on stroke volume variation (SVV), and we hypothesized that induced bradycardia alters the value of SVV. Landiolol, an ultra-short-acting adrenergic β1-receptor blocking agent, was reported to induce bradycardia without decreasing blood pressure. The initial aim of this prospective study was to investigate changes in SVV values by induced bradycardia in patients with good cardiac function.

Methods

At 30 min after anesthesia induction, if heart rate (HR) was >80 bpm, the patient was chosen as a subject. Ten ASA physical status I–II patients aged 38–75 years who were scheduled for elective abdominal surgery were included in this study. Baseline values were recorded, and then administration of landiolol was started at 125 μg/kg/min for 1 min and then continued at 40 μg/kg/min. SVV and other parameters were recorded at baseline and 3 min after continuous landiolol injection.

Results

Landiolol significantly decreased systolic arterial pressure, and diastolic arterial pressure, contrary to our expectations, and also HR, SVV, cardiac output, stroke volume index, and pressure of end-tidal CO2, whereas systemic vascular resistance values increased significantly.

Conclusions

SVV decreased after continuous administration of a β1-adrenergic blocker, probably because of a decrease in the difference of maximum stroke volume (SV) and minimum SV, or the downward shift of the Frank–Starling curve that occurred after landiolol administration. We believe that SVV values might be overestimated or misinterpreted when HR is decreased by landiolol and might not necessarily indicate that the patient is hypervolemic or normovolemic.

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Acknowledgments

This study was supported solely by departmental resources.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, 77 Tomita, Yaita, Tochigi, 329-2145, Japan

    Zen’ichiro Wajima

  2. Department of Anesthesiology, International University of Health and Welfare Hospital, Tochigi, 329-2763, Japan

    Zen’ichiro Wajima

  3. Department of Anesthesiology, Kaken Hospital, Chiba, 272-0827, Japan

    Toshiya Shiga

  4. Department of Anesthesia, Shonan Kamakura General Hospital, Kanagawa, 247-8533, Japan

    Kazuyuki Imanaga

  5. Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, 270-1694, Japan

    Tetsuo Inoue

Authors
  1. Zen’ichiro Wajima
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  2. Toshiya Shiga
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  3. Kazuyuki Imanaga
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  4. Tetsuo Inoue
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Correspondence to Zen’ichiro Wajima.

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Wajima, Z., Shiga, T., Imanaga, K. et al. Does intravenous landiolol, a β1-adrenergic blocker, affect stroke volume variation?. J Anesth 27, 890–894 (2013). https://doi.org/10.1007/s00540-013-1622-8

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  • DOI: https://doi.org/10.1007/s00540-013-1622-8

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