Population Pharmacokinetics of Midazolam Administered by Target Controlled Infusion for Sedation following Coronary Artery Bypass Grafting

Zomorodi, Katayoun; Donner, A.; Somma, Jacques; Barr, Juliana; Sladen, Robert N.; Ramsay, James G.; Geller, Eran; Shafer, Steven L.

doi:10.1097/00000542-199812000-00020

Cited by 53 publications

(21 citation statements)

References 29 publications

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“…Most of the included studies had careful infusion protocols for both drugs. And although midazolam has a rapid onset time of 2 to 3 minutes, the effect site concentration peaks only after approximately 13 minutes [20,21]. Repeat boluses may be given too early, which can lead to overdosing and hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

et al. 2017

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ObjectivesTo systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation.Materials and MethodsWe searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam. Exclusion criteria: patients in intensive care, pediatric subjects and per protocol use of additional sedative medication other than rescue medication. Outcome measures for efficacy comparison were patient and clinician satisfaction scores and pain scores; outcome measures for safety comparison were hypotension, hypoxia, and circulatory and respiratory complications.ResultsWe identified 89 papers, of which 12 satisfied the inclusion and exclusion criteria; 883 patients were included in these studies. Dexmedetomidine was associated with higher patient and operator satisfaction than midazolam. Patients receiving dexmedetomidine experienced less pain and had lower analgesic requirements. Respiratory and hemodynamic safety were similar.ConclusionsDexmedetomidine is a promising alternative to midazolam for use in procedural sedation. Dexmedetomidine provides more comfort during the procedure for the patient and clinician. If carefully titrated, the safety profiles are similar.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

et al. 2017

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“…Bayesian studies on midazolam have been previously reported in the literature, but have been focused on the paediatric population (Burtin et al 1994;Lee et al 1999). A study has been performed in adult intensive care patients during midazolam short-term infusion (Zomorodi et al 1998), but no data are available following long-term midazolam infusion.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the estimation of midazolam concentrations and pharmacokinetic parameters in intensive care patients using a bayesian pharmacokinetic software (PKS) according to sparse sampling approach

Bolon

Bastien

Flamens

et al. 2003

Journal of Pharmacy and Pharmacology

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The aim of the study was to assess the performance of a bayesian program (PKS System, Abbott) for predicting midazolam concentrations and pharmacokinetic parameters in intensive care patients by comparing the pharmacokinetic parameters estimated by PKS to those calculated according to rich data. The study involved 42 patients receiving midazolam infusion for two hours or for several days. The program was used to predict plasma midazolam concentrations after feedback of 1, 2 or 3 concentrations. High correlation between observed and estimated concentrations was shown (r(2) > 0.992). Mean prediction error, mean absolute prediction error and root mean squared error were low for the patients of the reference and validation groups. From two or three feedback concentrations, midazolam pharmacokinetic parameters estimated by PKS were statistically comparable with those obtained using a rich pharmacokinetic analysis (P > 0.05 paired Wilcoxon test). Thus, PKS is useful for predicting midazolam concentrations and pharmacokinetic parameters when at least two feedback concentrations are known. This software seems to be appropriate for providing significant help to the clinician for midazolam dosage adjustment, according to midazolam concentrations and clinical sedation.

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“…In the structure model selection, to describe the MDZ concentration–time profiles, several pharmacokinetic models (one‐ and two‐compartment models with first‐order elimination, with and without interpatient variability of several parameters) were tested. In previous studies, the pharmacokinetics of MDZ was described using two‐ or three‐compartment models . A one‐compartment model was used to describe the pharmacokinetics of MDZ in this study because the bootstrap confidence intervals of the parameter estimates for the two‐compartment model were near zero (data not shown).…”

Section: Resultsmentioning

confidence: 99%

Semi-mechanistic autoinduction model of midazolam in critically ill patients: population pharmacokinetic analysis

et al. 2016

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Population Pharmacokinetics of Midazolam Administered by Target Controlled Infusion for Sedation following Coronary Artery Bypass Grafting

Cited by 53 publications

References 29 publications

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

Evaluation of the estimation of midazolam concentrations and pharmacokinetic parameters in intensive care patients using a bayesian pharmacokinetic software (PKS) according to sparse sampling approach

Semi-mechanistic autoinduction model of midazolam in critically ill patients: population pharmacokinetic analysis

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