Comparative Cardiovascular Effects of Midazolam and Thiopental in Healthy Patients

Lebowitz, P. W.; Côté, Marceline; Daniels, Alfred L.; Ramsey, F. M.; Martyn, Jeevendra; Teplick, Richard; Davison, J.Kenneth

doi:10.1097/00132586-198306000-00018

Cited by 10 publications

(12 citation statements)

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“…This effect is similar to findings from previous studies [11,12,13], and could be partly attributed to decrease in systemic vascular resistance caused by midazolam. The reduction in catecholamines resulting from anxiolysis leads ultimately to reduction of heart rate and blood pressure.…”

Section: Discussionsupporting

confidence: 91%

Los beneficios de la reducción de la ansiedad con Midazolam en una Unidad de Cirugía Podológica en el Reino Unido

Tollafield

Duarte

Ashford

et al. 2014

Rev. Int. Cienc. Podol.

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Sedation has been frequently used alongside many surgical interventions under local anaesthetics (LA). In podiatric surgery, there is a paucity of literature on the effects of sedation drugs on surrogate measures of patients' physiological signs. General anaesthetic is practised more frequently than sedation assisted local anaesthetic in podiatry. The aim of this audit was to analyse blood pressure (BP) and heart rate (HR) against the administration of midazolam.A retrospective assessment of sedation notes prior to podiatric procedures undertaken during the years 2008/2009 was performed. BP (systolic/diastolic mm Hg) and heart rate (beats/min) were recorded prior to the administration of midazolam and for the first 30 minutes following administration.Ninety-four consecutive patients (74 women, 20 men) were admitted for podiatric surgery. Ninety-nine interventions were performed, with five of the subjects undergoing two procedures. The mean age was 59±13.5 years (21-87) and average midazolam administered 2.8±1.3 mg (0.5-8). Average BP prior to midazolam was 148/85 mm Hg and HR 80. At 30 minutes assessment BP was 136/80 and HR 71. BP and HR differences were significantly different at p<0.001 to the reading prior to administration.The results presented indicate the use of such a drug as an adjunct to LA in a sedation context has favourable results. Keywords: midazolam; sedation; audit; podiatric surgery. ReSuMeNLa sedación se ha utilizado con frecuencia junto a muchas de las intervenciones quirúrgicas realizadas bajo anestésicos locales (AL) . En la cirugía podológica, hay una escasez de literatura sobre los efectos de la sedación ante las señales fisiológicas de los pacientes. La anestesia general se practica con mayor frecuencia que la sedación con anestésico local en podología . El objetivo de esta estudioa fue analizar la presión arterial ( PA) y frecuencia cardiaca (FC ) en contra de la administración de midazolam.Se realizó una evaluación retrospectiva de las registros de sedación antes de los procedimientos de podología llevadas a cabo durante los años 2008/2009 . La PA ( sistólica / diastólica mm de Hg ) y la FC ( latidos / min ) se registraron antes de la administración de midazolam y durante los primeros 30 minutos después de la administración .Noventa y cuatro pacientes ( 74 mujeres, 20 hombres) fueron ingresados para cirugía podológica . Se realizaron Noventa y nueve intervenciones , con cinco de los sujetos sometidos a dos procedimientos. La edad media fue de 59 David R. Tollafield et al.

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Section: Discussionsupporting

confidence: 91%

Los beneficios de la reducción de la ansiedad con Midazolam en una Unidad de Cirugía Podológica en el Reino Unido

Tollafield

Duarte

Ashford

et al. 2014

Rev. Int. Cienc. Podol.

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“…The reduction in MAP after midazolam induction in both healthy (Marty et al, 1986a;Lebowitz et al,1982) and ill patients (Marty et al, 1986b;Lebowitz et al, 1983) is reported to be 15-19% when measuring the blood pressure invasively, despite doses ranging from 0.15 to 0.30 mg kg'-1. This supports our findings of a maximal effect on blood pressure evoked by midazolam at lower, sedative doses with a maximum decrease on MAP of 18%.…”

Section: Resultsmentioning

confidence: 99%

Respiratory and cardiovascular effects in relation to plasma levels of midazolam and diazepam.

Sunzel

Paalzow

Berggren

et al. 1988

Brit J Clinical Pharma

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“…Arterial blood pressure and systemic vascular resistance increased after 3 min following thiopentone administration and decreased following midazolam administration 156 [II]. On the other hand, no differences in arterial blood pressure and heart rate, 157 stroke volume, cardiac output or systemic vascular resistance 158 were demonstrated in these studies [II]. Table 8 Recommendations for hypnotic drugs considering the haemodynamic system.…”

Section: Thiopentone and Midazolammentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

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Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high‐grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients should be given by, or under very close supervision by, experienced anaesthesiologists. Problems with the airway and the circulation must be anticipated. The risk of aspiration must be judged for each patient. Pre‐operative gastric emptying is rarely indicated. For pre‐oxygenation, either tidal volume breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre‐oxygenation in the obese patients should be performed in the head‐up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1–1.5 mg/kg is preferred. Outside the operation room, rapid sequence intubation is also considered the safest method. For all patients, precautions to avoid aspiration and other complications must also be considered at the end of anaesthesia.

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Comparative Cardiovascular Effects of Midazolam and Thiopental in Healthy Patients

Cited by 10 publications

References 0 publications

Los beneficios de la reducción de la ansiedad con Midazolam en una Unidad de Cirugía Podológica en el Reino Unido

Los beneficios de la reducción de la ansiedad con Midazolam en una Unidad de Cirugía Podológica en el Reino Unido

Respiratory and cardiovascular effects in relation to plasma levels of midazolam and diazepam.

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

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