Study on the usefulness of precise and simple dynamic balance tests for the evaluation of recovery from intravenous sedation with midazolam and propofol

Fujisawa, Toshiaki; Takuma, Shigeru; Koseki, Hiroyo; Kimura, Kunie; Fukushima, Kazuaki

doi:10.1017/s0265021506001876

Cited by 9 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We previously demonstrated that this is also true when maintaining sedation impaired balance [8] and sleep-deprived balance [12]. The results in the current study are in agreement with previous findings that propofol impairs postural steadiness, but less so than midazolam [3,4].…”

Section: Resultssupporting

confidence: 93%

“…Fujisawa demonstrated that computerized dynamic posturography was affected by midazolam [1], that these effects persisted longer in the elderly than in young people [2], and that the effects were less persistent with propofol sedation [3]. These authors further demonstrated that the results of the timed up and go test, in which a patient stood up, walked five meters, turned, and returned to their chair, correlated with the computerized dynamic posturography score [3,4]. Although computerized dynamic posturography and the timed up and go test may be sensitive measures of recovery, these tests may not be appropriate for all patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

Je¹,

Tietäväinen²,

Otero³

et al. 2017

Med Res Innov

View full text Add to dashboard Cite

Background: Measurement of the residual effects of sedatives on fitness for ambulation is typically performed with subjective measures, if at all. Previous efforts to objectively measure these effects employed dynamic posturography with expensive equipment that is not easily brought to the bedside and carries a risk of patient injury. A simple test employing consumer off-the-shelf technology that exposes the patient to no more risk than standing still might permit a more reliable assessment of fitness for discharge. We have previously shown that a simple tester, using a Nintendo Wii® Balance board and software that determined fuzzy sample entropy of postural sway can separate outpatients' postural steadiness before (PRE) and after (POST) endoscopy with midazolam/fentanyl conscious sedation. Propofol/fentanyl monitored anesthesia care also alters balance, but recovery is known to be more rapid. We hypothesized that the ability to detect decrements in postural steadiness with fuzzy sample entropy following monitored anesthesia care would be less than that seen in conscious sedation.

show abstract

Section: Resultssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

Je¹,

Tietäväinen²,

Otero³

et al. 2017

Med Res Innov

View full text Add to dashboard Cite

show abstract

“…Fujisawa et al. reported that 0.07 mg.kg −1 midazolam reduced grip strength more than propofol at predicted effect‐site concentration of 2.2 μg.ml −1 . Because benzodiazepines such as midazolam produce centrally acting muscle relaxation via α 2 ‐GABA A receptors , it has been suggested that this reduction in grip strength negates the increase in grip strength induced by propofol.…”

Section: Discussionmentioning

confidence: 99%

The combined effects of midazolam and propofol sedation on muscle power

2013

View full text Add to dashboard Cite

SummaryWe performed a randomised, crossover study to investigate the effects of intravenous sedation on grip strength and bite force. Twenty male volunteers received a bolus intravenous injection of midazolam (0.02 mg.kg À1 ) together with a 30-min propofol infusion designed to achieve an effect-site concentration of 1.0 lg.ml À1. Observed variables included bispectral index, observer's assessment of alertness/sedation, correct answer rate of Stroop colour-word test, grip strength and bite force. Grip strength decreased from a median (IQR [range]) of 483 (443-517 [380-586]) N to 358 (280-405 [108-580]) N (p < 0.001) during sedation and recovered following flumazenil administration, while bite force increased from

show abstract

“…As a result, dentists sometimes suffer from control behavioural management of patients. There have been a number of detailed studies on central nervous system (CNS) effects, circulatory and respiratory effects, and wakening with intravenous sedation by midazolam or propofol [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , however, only few studies assessing physical movement or muscle power during sedation [19] , [20] .…”

Section: Introductionmentioning

confidence: 99%

Muscle power during intravenous sedation

Matsuura

2017

Japanese Dental Science Review

View full text Add to dashboard Cite

SummaryIntravenous sedation is effective to reduce fear and anxiety in dental treatment. It also has been used for behavior modification technique in dental patients with special needs. Midazolam and propofol are commonly used for intravenous sedation. Although there have been many researches on the effects of midazolam and propofol on vital function and the recovery profile, little is known about muscle power. This review discusses the effects of intravenous sedation using midazolam and propofol on both grip strength and bite force. During light propofol sedation, grip strength increases slightly and bite force increases in a dose-dependent manner. Grip strength decreases while bite force increases during light midazolam sedation, and also during light sedation using a combination of midazolam and propofol. Flumazenil did not antagonise the increase in bite force by midazolam. These results may suggest following possibilities; (1) Activation of peripheral benzodiazepine receptors located within the temporomandibular joint region and masticatory muscles may be the cause of increasing bite force. (2) Propofol limited the long-latency exteroceptive suppression (ES2) period during jaw-opening reflex. Thus, control of masticatory muscle contraction, which is thought to have a negative feedback effect on excessive bite force, may be depressed by propofol.

show abstract

Study on the usefulness of precise and simple dynamic balance tests for the evaluation of recovery from intravenous sedation with midazolam and propofol

Abstract: The timed 'up & go' and maximum-speed walking tests are useful simple dynamic balance tests well correlated with precise computerized dynamic posturography for the evaluation of the recovery of dynamic balance from midazolam sedation in younger adults.

Cited by 9 publications

References 29 publications

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

The combined effects of midazolam and propofol sedation on muscle power

Muscle power during intravenous sedation

Contact Info

Product

Resources

About