A comparative study on the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate of patients with atrial fibrillation during anesthesia period
10.3760/cma.j.issn.0253-3758.2010.11.006
- VernacularTitle:艾司洛尔、胺碘酮和地尔硫(艹卓)治疗麻醉期间快室率心房颤动的比较
- Author:
She-Liang SHEN
1
;
You-Cheng ZHAO
Author Information
1. 浙江省人民医院
- Keywords:
Esmolol;
Amiodarone;
Diltiazem;
Atrial fibrillation;
Heart rate
- From:
Chinese Journal of Cardiology
2010;38(11):989-992
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate in patients with atrial fibrillation (AF) during anesthesia period. Methods Ninety AF patients with rapid atrial ventricular rate ( ≥ 120 beats/min) in anesthesia period were randomly divided into 3 groups ( n = 30 each: group Ⅰ patients were treated with intravenous group Ⅱ patients were treated with intravenous amiodarone (loading dose: 3 mg/kg for 10 minutes, followed with intravenous infusion of 1 mg/min); group Ⅲ patients were treated with intravenous diltiazem ( 0. 25 mg/kg for 5 minutes). The heart rate, blood pressure, rhythm were recorded before treatment, at 5, 10,15, 30, 60 and 90 min after treatment. The reacting time, side effects including hypotension, bradycardia,nausea, vomiting, dizziness, etc, were analyzed. Results The mean reacting time was significantly shorter in group Ⅰ (4.3 ±2. 1)min than in group Ⅱ (19.2 ±8.5) min and in group Ⅲ (8.5 ±3.4) min (P＜0. 05 ). The mean reacting time in group Ⅲ was significantly shorter than in group Ⅱ ( P ＜ 0. 05 ). The total effective rate were similar among the groups ( 86. 7%, 90.0% and 83.3% with a mean decrease in heart ventricular rate by 42.4%, 42% and 41.9% of the baseline level in group Ⅰ , group Ⅱ and group Ⅲ,respectively). The incidence of total side effect was significantly lower in group Ⅱ ( 10% ) than in group Ⅰ ( 16. 7% ) and group Ⅲ (20%, P ＜ 0. 05). Conclusions Intravenous esmolol, amiodarone and diltiazem are all equally effective and safe on controlling rapid ventricular rate in patients with atrial fibrillation during the anesthesia period. Esmolol use is associated with the shortest mean reacting time and amiodaron use is associated with the lowest total side effect rate in this patient cohort.
