Background: beta-Adrenergic blocking agents may interact with anaesthetics, and several studies suggest that beta-blockers attenuate electroencephalographic responses during general anaesthesia. We have investigated the influence of landiolol, an ultra-short-acting beta 1-adrenoceptor antagonist, on the electroencephalographic effect of isoflurane in pigs.

Methods: Ten swine were anaesthetized through inhalation of 2% isoflurane. The inhalational concentration was then decreased to 0.5% and maintained for 25 min, before being returned to 2% and maintained for a further 25 min (control period). After control measurements, infusion of landiolol (at 0.125 mg kg(-1) min(-1) for 1 min, and then at 0.04 mg kg(-1) min(-1)) was started. After a 20 min stabilization period, the inhalational concentration was varied as in the control period (40 gamma landiolol). Finally, infusion of landiolol was increased from 0.04 to 0.2 mg kg(-1) min(-1), and after a 20 min stabilization period, the inhalational concentration was again varied as in the control period (200 gamma landiolol). End-tidal isoflurane concentrations and spectral edge frequencies were recorded throughout the study. Analysis of the pharmacodynamics was performed using a sigmoidal inhibitory maximal effect model for spectral edge frequency vs effect-site concentration.

Results: There were no significant differences in the effect of isoflurane among the conditions used. Landiolol did not shift the concentration-effect relationship [the effect-site concentration that produced 50% of the maximal effect was 1.35 (0.17)% under control conditions, 1.30 (0.12)% at 40 gamma landiolol, and 1.38 (0.30)% at 200 gamma landiolol].

Conclusion: Landiolol does not alter the electroencephalographic effect of isoflurane.

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http://dx.doi.org/10.1093/bja/ael069DOI Listing

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