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Titolo:
Atropine prevents midazolam-induced core hypothermia in elderly patients
Autore:
Matsukawa, T; Ozaki, M; Nishiyama, T; Imamura, M; Iwamoto, R; Iijima, T; Kumazawa, T;
Indirizzi:
Yamanashi Med Univ, Dept Anesthesia, Yamanashi 4093898, Japan Yamanashi Med Univ Yamanashi Japan 4093898 sia, Yamanashi 4093898, Japan
Titolo Testata:
JOURNAL OF CLINICAL ANESTHESIA
fascicolo: 7, volume: 13, anno: 2001,
pagine: 504 - 508
SICI:
0952-8180(200111)13:7<504:APMCHI>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
SHIVERING THRESHOLDS; NONLINEAR DECREASES; SLIGHTLY INCREASES; SWEATING THRESHOLD; HEAT-FLOW; VASOCONSTRICTION; TEMPERATURE; ANESTHESIA; HUMANS; ISOFLURANE;
Keywords:
anesthesia; atropine, midazolam, premedication; temperature; hypothermia, sweating, thermoregulation, vasoconstriction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Matsukawa, T Yamanashi Med Univ, Dept Anesthesia, Yamanashi 4093898, JapanYamanashi Med Univ Yamanashi Japan 4093898 i 4093898, Japan
Citazione:
T. Matsukawa et al., "Atropine prevents midazolam-induced core hypothermia in elderly patients", J CLIN ANES, 13(7), 2001, pp. 504-508

Abstract

Study Objective: To test the hypothesis that core temperature is well preserved when atropine and midazolam are combined. Design: Randomized, blinded study. Setting: Department of Anesthesia, Yamanashi Medical University. Patients: 40 elderly, ASA physical status I and II patients (aged more than 60 years). Interventions: Patients were randomly assigned (n = 10 per group) to premedication with: 1) saline control; 2) midazolam 0.05 mg/kg; 3) atropine 0.01mg/kg; and 4) midazolam 0.05 mg/kg combined with atropine 0.01 mg/kg. All premedication was given on the ward at approximately 8:30 AM, approximate to 30 minutes before induction of anesthesia. Measurements and Main Results: Core temperatures were measured at the right tympanic membrane. Mean skin temperature was calculated as 0.3 X (T-chest+ T-arm) + 0.2 X (T-thigh + T-calf). Fingertip perfusion was evaluated using forearm minus fingertip and calf minus toe, skin-surface temperature gradients. Temperatures were evaluated at the time of premedication and 30 minutes later, just before induction of anesthesia. Core temperature remained nearly constant in the control patients (0.1 +/- 0.2 degreesC; mean +/- SD), whereas it decreased significantly in the patients given midazolam alone (-0.3 +/- 0.1 degreesC). Atropine alone increased core temperature (0.3 +/-0.2 degreesC), although the increase was not statistically significant. The combination of midazolam and atropine attenuated the hypothermia induced by midazolam alone (0.0 +/- 0.2 degreesC). Initial skin-temperature gradients exceeded 0 degreesC in all groups, indicating that the patients were vasoconstricted. The gradients were unchanged by premedication with saline or atropine. Midazolam significantly decreased the gradient (-1.8 +/- 1.1 C), as did the combination of midazolam and atropine (-1.4 +/- 0.9 degreesC). Conclusions: The thermoregulatory effects of benzodiazepine receptor agonist and cholinergic inhibitors oppose each other, and the combination leavescore temperature unchanged. 2001 by Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 10:01:16