Metoclopramide does not prolong duration of action of landiolol attenuating the hemodynamic response to induction of anesthesia and tracheal intubation

Landiolol is a new ultra-short-acting beta 1-selective adrenoreceptor antagonist, which is metabolized rapidly by plasma cholinesterase (PCHE). Metoclopramide has been shown to inhibit PCHE in vitro. Therefore, metoclopramide might prolong beta blocking effects of landiolol and spoil its ultimate-short-acting property. Just before induction of anesthesia, gynecological patients were randomly assigned to receive 0.2 mg/0.1 ml/kg landiolol and 2 ml saline (Landiolol group; n = 20), 0.2 mg/0.1 ml/kg landiolol and 10 mg metoclopramide/2 ml solution (Landiolol-M group; n = 20), or 0.1 ml/kg saline and 2 ml saline (Control group; n = 20). Tracheal intubation was performed 3 min after induction of anesthesia. Heart rate and blood pressure were recorded. Landiolol with or without metoclopramide similarly inhibited increase in heart rate after induction of anesthesia and tracheal intubation. However, changes in blood pressure were not affected. Metoclopramide at induction of anesthesia did not prolong duration of action of landiolol attenuating the hemodynamic response to induction of anesthesia and tracheal intubation.