Haemodynamic changes during induction of anaesthesia with midazolam and diazepam (Valium) in patients undergoing coronary artery bypass surgery

Kawar, P.; Carson, Ian; Clarke, R.S.J.; Dundee, John W.; Lyons, Seán

doi:10.1111/j.1365-2044.1985.tb11002.x

Cited by 30 publications

(13 citation statements)

References 10 publications

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“…The PRA, Ang II, blood pressure and HR in the midazolam group were markedly higher than those in the other two groups during anesthesia induction and tracheal intubation (P<0.05), which is basically identical to the reports by Kwa et al [2] that midazolam anesthesia induction can not reduce the cardiovascular response during tracheal intubation. Attention should be paid to the fact that fierce hemodynamic fluctuation in the elderly patients is likely to induce heart, brain and kidney events.…”

Section: Discussionsupporting

confidence: 80%

Comparison of Various Anesthesia Induction Methods for the Anesthesia in Elderly Patients in the Abdominal Surgery

et al. 2017

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Abstract. Objective: To investigate the anesthesia induction methods in the elderly in surgeries. Methods: 60 cases of elderly patients in the Abdominal Surgery with ASA grade 1 to 3 were selected and randomly divided into three groups; intravenous injection of 4ug/kg of fentanyl and 0.1mg/kg of vecuronium bromide was conducted at first, and then group A was injected with 0.2mg/kg of midazolam, group B with 1.5mg/kg of propofol, and group C with 0.1mg/kg of midazolam and 1.0mg/kg of propofol for anesthesia induction within 1 min, and then the tracheal intubation was conducted. The effective time of anesthesia induction and the circulatory changes, as well as changes of PRA and Ang II values before anesthesia (T0), after anesthesia induction (T1), immediately after intubation (T3), and 5 min after intubation (T3) were observed. Results: The effective time of anesthesia induction was shorter in group C than in group A (P<0.05), and that was similar between group C and group B (P>0.05); compared with T0, the PRA and Ang II values in the three groups showed a decreasing trend at T1, T2 and T3, with the decrease being distinct at T1 (P<0.05); at T2, the PRA and Ang II values were significantly increased in group A (P<0.05), which were remarkably higher than those in group B and group C at the same period (P<0.05). The mean arterial pressure (MAP) and heart rate (HR) at T2 were notably increased in group A (P<0.05), while those were outstandingly reduced at T1 in group B (P<0.05), and group C had mild circulatory changes (P>0.05). The saturation of pulse oximetry (SPO2) was maintained between 97% and 100%. Conclusion: The combined use of midazolam and propofol is the ideal method for anesthesia induction in the elderly.

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Section: Discussionsupporting

confidence: 80%

Comparison of Various Anesthesia Induction Methods for the Anesthesia in Elderly Patients in the Abdominal Surgery

et al. 2017

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“…The falls in systemic blood pressure following the intravenous injection of both drugs were smaller than those reported by other investigators [9][10][11][12][13]. Samuelson et al [9] showed a decrease in MAP of more than 20% 5 min after the injection of midazolam 0.2 mg/kg or diazepam 0.5 mg/ kg in patients with ischemic heart disease.…”

Section: Discussionmentioning

confidence: 62%

The effects of low-dose midazolam for induction of high-dose fentanyl anesthesia for coronary artery bypass graft

et al. 1994

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A small dose of midazolam 0.06 mg/kg or diazepam 0.15 mg/kg was used for induction of high-dose fentanyl (50 μg/kg) anesthesia in patients undergoing coronary artery bypass grafting operation. Hemodynamic variables were measured 5 min after the injection of midazolam or diazepam, after the end of the fentanyl infusion, and following endotracheal intubation. Midazolam and diazepam caused a slight but significant decrease in mean arterial pressure (-9.8%) and -11.8%), respectively) and a further significant depression was observed in the diazepam group but not in the midazolam group after fentanyl. Although the cardiac index was maintained in patients who received madazolam, a significant decrease was observed in the diazepam group (-28.5%) after administration of fentanyl. Heart rate was decreased in the diazepam group but not in the midazolam group. Therefore, a small dose of midazolam may be a suitable induction agent for high-dose fentanyl anesthesia in patients with coronary artery disease.

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“…[24][25][26][27][28][29][30][31][32][33][34][35][36] In studies of patients with limited cardiac reserve, induction with 0.2 to 0.3 mg/ kg of midazolam causes mean decreases in MAP ranging from about 10 mm Hg to about 20 mm Hg. 16,[37][38][39][40] These modest hemodynamic effects were seen using dosages of midazolam that were two to three times the dose (0.1 mg/kg) we used as our cutoff for underdosing, and four to six times the mean dose we observed emergency physicians using in adult patients. One additional study of patients with severe mitral stenosis 41 showed a decrease in MAP of only 6 mm Hg after induction with 0.07 mg/kg of morphine plus 0.1 mg/kg of midazolam; MAP rapidly returned to baseline after intubation.…”

Section: Discussionmentioning

confidence: 99%

“…Adverse hemodynamic responses to intubation, especially catecholamine release with resultant hypertension and tachycardia, are significantly attenuated by adequate doses of induction agents. [16][17][18][19][20] 3. Laryngoscopy and intubation during RSI are attempted at the earliest possible time after the neuromuscular blocking agent is administered.…”

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confidence: 99%

Underdosing of Midazolam in Emergency Endotracheal Intubation

Sagarin

Barton

Sakles

et al. 2003

Academic Emergency Medicine

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Haemodynamic changes during induction of anaesthesia with midazolam and diazepam (Valium) in patients undergoing coronary artery bypass surgery

Cited by 30 publications

References 10 publications

Comparison of Various Anesthesia Induction Methods for the Anesthesia in Elderly Patients in the Abdominal Surgery

Comparison of Various Anesthesia Induction Methods for the Anesthesia in Elderly Patients in the Abdominal Surgery

The effects of low-dose midazolam for induction of high-dose fentanyl anesthesia for coronary artery bypass graft

Underdosing of Midazolam in Emergency Endotracheal Intubation

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