Document Detail

Successful management of cesarean section in a patient with Romano-Ward syndrome using landiolol, a selective and short-acting beta1 receptor antagonist.
MedLine Citation:
PMID:  15875139     Owner:  NLM     Status:  MEDLINE    
Romano-Ward (R-W) syndrome is an autosomal dominant hereditary disorder and is characterized by a prolonged QT interval on the electrocardiogram (ECG), syncope, and sudden death. We report here a case of cesarian section in a patient with R-W syndrome whose QT prolongation was successfully managed with landiolol, a selective beta1 receptor blocker. A 25-year-old woman with R-W syndrome was scheduled for cesarean section. In the operating room, the patient's ECG showed tachycardia (102 beats x min(-1)) and marked QT prolongation (QTc = 0.56 s). After spinal anesthesia, the patient's heart rate (HR) increased to 130 beats/min accompanied by a slight decrease in arterial blood pressure to 97/57 mmHg and the QTc was prolonged to 0.57 s. Landiolol was continuously infused at a rate of 0.04 x min(-1) and the HR gradually decreased to 80-90 beats x min(-1) accompanied by the normalization of QTc to 0.48 s. We thought that the use of landiolol was more rational and was preferable to a nonselective beta receptor blocker for a term-pregnant woman because blockade of the beta2 receptor might cause uterine contraction. After the use of landiolol, intraoperative and postoperative courses in both the patient and the baby were uneventful.
Kozue Kubo; Kohei Murao; Shinichi Nakao; Tomoko Kanoda; Makiko Yamada; Koh Shingu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of anesthesia     Volume:  19     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2005  
Date Detail:
Created Date:  2005-05-05     Completed Date:  2005-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  174-6     Citation Subset:  IM    
Department of Anesthesiology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi 570-8507, Japan.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Cesarean Section
Morpholines / therapeutic use*
Pregnancy Complications, Cardiovascular / drug therapy*,  physiopathology
Romano-Ward Syndrome / drug therapy*,  physiopathology
Urea / analogs & derivatives*,  therapeutic use*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Morpholines; 133242-30-5/landiolol; 57-13-6/Urea

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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