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Titolo:
A small dose of midazolam decreases the time to achieve hypnosis without delaying emergence during short-term propofol anesthesia
Autore:
Adachi, YU; Watanabe, K; Higuchi, H; Satoh, T;
Indirizzi:
Natl Def Med Coll, Dept Anesthesiol, Tokorozawa, Saitama 3598513, Japan Natl Def Med Coll Tokorozawa Saitama Japan 3598513 Saitama 3598513, Japan
Titolo Testata:
JOURNAL OF CLINICAL ANESTHESIA
fascicolo: 4, volume: 13, anno: 2001,
pagine: 277 - 280
SICI:
0952-8180(200106)13:4<277:ASDOMD>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
GENERAL-ANESTHESIA; PREMEDICATION; REQUIREMENTS; INDUCTION; SEDATION; BUPIVACAINE; RECOVERY;
Keywords:
drug interactions; emergence; flumazenil; hypnosis; midazolam; propofol;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Adachi, YU Natl Def Med Coll, Dept Anesthesiol, 3-2 Namiki, Tokorozawa, Saitama 3598513, Japan Natl Def Med Coll 3-2 Namiki Tokorozawa Saitama Japan 3598513 n
Citazione:
Y.U. Adachi et al., "A small dose of midazolam decreases the time to achieve hypnosis without delaying emergence during short-term propofol anesthesia", J CLIN ANES, 13(4), 2001, pp. 277-280

Abstract

Objective: To evaluate the effect of a small dose of midazolam (10 mug kg(-1)) on induction and emergence during short-term propofol anesthesia and to investigate the effects of subsequent administration flumazenil. Design: Double-blinded, prospective, randomized study. Setting: Operating room of a medical college hospital. Patients: 30 male ASA physical status I. and II patients (ages 51 to 75) scheduled for minor surgery under spinal anesthesia. Interventions: Patients were randomly allocated to one of three groups: the placebo-propofol-placebo (PP) group, the midazolam-propofol-placebo (MP) group, or the midazolam-propofol-flumazenil (MF) group. After administeringplacebo or midazolam (10 mug kg(-1)), propofol 250 mug kg(-1) min(-1) was infused. Immediately after confirming that the patient was hypnotized, we terminated the propofol infusion and administered placebo or flumazenil (5 mug kg(-1)). Measurements: The dose and the times required to achieve hypnosis (the first endpoint) and to emerge from anesthesia (the second endpoint). The plasma concentration at each endpoint was determined. Main Results: Midazolam significantly decreased the dose and time needed to achieve hypnosis [PPvs. IMP, 66 +/- 14 vs. 48 +/- 15 mg, 260 +/- 55 vs. 179 +/- 44 sec, respectively (mean I SD)]. Thus, the plasma concentration ofpropofol at hypnosis was significantly lower (PP vs. MP, 3.31 +/- 0.78 vs.2.41 +/- 0.57 mug mL(-1)). The time to emerge from anesthesia was not prolonged by midazolam, and was further shortened by administration of flumazenil (PP, IMP vs. MF, 237 +/- 77, 207 +/- 71 s vs. 126 +/- 56 sec, respectively). Flumazenil also reversed the reduction in propofol concentration induced by midazolam at emergence (PP, IMP, and IMF, 0.54 +/- 0.17, 0.37 +/- 0.15, and 0.59 +/- 0.22 mug mL(-1), respectively). Conclusions: Coadministration of 10 mug kg(-1) midazolam decreases the dose and time required to achieve hypnosis with propofol induction without delaying emergence from anesthesia. Additional administration of flumazenil further shortens the time to emerge from midazolam-propofol anesthesia. (C) 2001 by Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 05:20:05