Midazolam Sedation during Spinal Anesthesia: Optimal Dosage.

Abstract

Optimal dose of midazolam for sedation during spinal anesthesia was investigated. One hundred and fifteen patients for spinal anesthesia (analgesic area below Th4), 30 to 70 years old, were divided into five groups according to midazolam dose: 0.025mg/ kg (27 cases), 0.05mg/kg (25 cases), 0.075mg/kg (23 cases), 0.1mg/kg (25 cases), and 0.125mg/kg (15 cases). Responses to verbal command and ciliary reflex were significantly more depressed in the 0.05, 0.075, 0.1, and 0.125mg/kg groups than in the 0.025mg/ kg group. The sedative effect of 0.025mg/kg of midazolam was therefore considered to be weak. In more than 25% of cases in the 0.075, 0.1, and 0.125mg/kg groups, respiration was depressed by dropped tongue. Respiratory rate increased significantly in the 0.1 and 0.125mg/kg groups. The numbers of cases who required vasopressor, who had body motion or nausea and vomiting did not differ much among the five groups.Blood pressure was more stable in the 0.025 and 0.05mg/kg groups than in the other three groups.The stabilities of circulation and respiration were better in the 0.025 and 0.05mg/kg groups than in the others.It was concluded that the optimal dose of midazolam for sedation during spinal anesthesia in patients aged 30-70 years is 0.05mg/ kg.

A Comparison of Dexmedetomidine and Midazolam for Sedation in Gynecologic Surgery Under Epidural Anesthesia

“…Bolus administration of midazolam 0.05 mg/kg was reported to give enough amnesia and sedation without any adverse effects on hemodynamics and respiration [25]. But in our study 8 of the 63 MDZ patients experienced respiratory depression requiring intervention.…”

Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

“…Bolus administration of midazolam 0.05 mg Á kg -1 was reported to give enough sedation and amnesia without any adverse effects on hemodynamics and respiration in patients aged 30-70 yr under spinal anesthesia. 15 Therefore, midazolam 0.05 mg Á kg -1 was administered to the patients in this study.…”

Dose-finding study of intravenous midazolam for sedation and amnesia during spinal anesthesia in patients premedicated with intramuscular midazolam

“…For this purpose, bolus administration of midazolam is reported to give enough sedation during spinal anesthesia [1,2]. Patients would be comfortable, with freedom from anxiety, if they do not have the memory of surgery [3].…”

“…Patients would be comfortable, with freedom from anxiety, if they do not have the memory of surgery [3]. In the previous study [1], intravenous midazolam 0.05 mg·kg Ϫ1 was judged as adequate for sedation and amnesia of patients aged 30-70 years under spinal anesthesia. In that study, intramuscular hydroxyzine was used as a premedication.…”