• Koichi Nomoto, Takashi Suzuki, Kazuyuki Serada, Katsunori Oe, Tatsuya Yoshida, and Sayoko Yamada.
• Department of Anesthesiology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Yokohama 224-8503, Japan.
• J Anesth. 2006 Jan 1;20(3):183-7.

PurposeThis study was done to evaluate the effect of landiolol, an ultra-short-acting beta-blocker, on the hemodynamic response and the duration of seizure activity during electroconvulsive therapy (ECT).MethodsWe designed a prospective, randomized, double-blinded, placebo-controlled, crossover study. Fourteen psychiatric patients participated. Landiolol (0.1 mg x kg(-1) or 0.2 mg x kg(-1)) or saline (placebo) was administered IV 1 min before the induction of anesthesia. Unconsciousness was induced with propofol 1.0 mg x kg(-1) IV, and muscle paralysis was produced with succinylcholine 0.6 mg x kg(-1) IV. Subsequently, electrical stimulus was administered to elicit a seizure, and the duration of the motor seizure activity was noted.ResultsThe heart rate (HR) and rate-pressure product (RPP) before ECT were significantly decreased in the 0.2 mg x kg(-1) landiolol group compared with these parameters in the placebo and 0.1 mg x kg(-1) landiolol groups. Both the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses significantly attenuated the degree of tachycardia and RPP after ECT in comparison with the placebo group. Pretreatment with 0.2 mg x kg(-1) landiolol resulted in a significantly shorter duration of motor seizure than that in the placebo group (21 +/- 13 s vs 27 +/- 12 s).ConclusionAs the landiolol dose of 0.2 mg x kg(-1) caused shorter seizure duration, and because the hemodynamic effects after ECT of the 0.1 mg x kg(-1) and 0.2 mg x kg(-1) doses were similar, it was concluded that a 0.1 mg x kg(-1) landiolol bolus was the appropriate dose pretreatment before ECT.

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