Midazolam premedication reduces propofol requirements for sedation during regional anesthesia. Can J Anaesth 2000 Jan;47(1):47-9
Date
01/08/2000Pubmed ID
10626718DOI
10.1007/BF03020731Scopus ID
2-s2.0-0034007764 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
PURPOSE: Propofol is often used for sedation during spinal anesthesia. We investigated the effects of midazolam premedication on the propofol requirements and incidence of complications during sedation.
METHODS: In a prospective randomized, controlled, and single-blinded study, 50 patients undergoing elective gynecological surgery were randomly divided into control and midazolam groups. Patients in the midazolam group received 2 mg midazolam im 30 min before arrival at the operation room. After spinal anesthesia was instituted with intrathecal injection of hyperbaric tetracaine, we provided sedation using continuous infusion of propofol. The level of sedation was controlled at a level between "eyes closed but rousable to command" and "eyes closed but rousable to mild physical stimulation" by adjusting the infusion rate. During sedation, the propofol requirements and complications were recorded and patients were asked, two hours after the end of operation, whether they remembered intraoperative events.
RESULTS: In the midazolam group, the loading dose, steady state infusion rate, and overall infusion rate of propofol were 0.74 mg x kg(-1), 2.86 mg x kg(-1) x hr(-1), and 3.32 mg x kg(-1) x hr(-1), respectively, which were about 17% lower than those in the control group (P<0.05). Moreover, midazolam premedication reduced the incidence of intraoperative memory (P < 0.05), but had no effects on other complications.
CONCLUSION: Midazolam premedication reduced propofol requirements and the incidence of intraoperative memory during sedation. These effects on sedation using propofol during spinal anesthesia are considered beneficial for patients.
Author List
Nakagawa M, Mammoto T, Hazama A, Kita T, Akamatsu T, Kambara N, Sakai T, Kishi YAuthor
Tadanori Mammoto MD, PhD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Anesthesia, Spinal
Female
Humans
Hypnotics and Sedatives
Midazolam
Middle Aged
Preanesthetic Medication
Propofol
Prospective Studies
Single-Blind Method
