Effects Of Intravenous Midazolam Research Articles

Effect of Intravenous Midazolam as Anxiolytic in Patients Undergoing Cataract Surgery under Peribulbar Block

Effect of Intravenous Midazolam as Anxiolytic in Patients Undergoing Cataract Surgery under Peribulbar Block

Effect of intravenous midazolam on intracranial pressure during endotracheal suctioning in patients with severe head injury

Abstract Background: Patients with severe traumatic brain injury (TBI) require elective ventilation and sedation to decrease intracranial pressure (ICP) and any increase in ICP may be detrimental for the outcome in these patients. Methods: This prospective study was done in a neurotrauma intensive care unit ( ICU )of a level 1 trauma centre in India over a one month period. All adult male patients with severe TBI on mechanical ventilation and monitored for ICP were included in this study. Baseline ICP was measured before starting endotracheal (ET) suctioning and serial readings were taken during and after ET suctioning. Patients were divided into two groups (control and intervention) with intervention group receiving intravenous bolus dose of 2 mg of midazolam before ET suction. Results: A total of 20 patients were enrolled during the study period. Both groups were well matched with regards to age and admission Glasgow coma scale (GCS). There were 10 patients in the midazolam group and 10 patients in the control group. The mean rise of ICP following ET suctioning in control group was found to be 24.1mm Hg ±11.1 as compared to 18.25 mm Hg ±-9.29 in the midazolam group ( P< 0.05). Conclusions: Significant rise in ICP from baseline occurs following ET suctioning in ventilated, severe TBI patients. Our study suggests that additional intravenous bolus of midazolam prior to suctioning may significantly reduce the rise in ICP and should be practiced by ICU nurses.

Effect of intravenous midazolam on intracranial pressure during endotracheal suctioning in patients with severe head injury

Effect of intravenous midazolam on intracranial pressure during endotracheal suctioning in patients with severe head injury

The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting

The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting

The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting: A Meta-Analysis.

Research has shown that high-risk surgical patients benefit from a multimodal therapeutic approach to prevent postoperative nausea and vomiting (PONV). Our group sought to investigate the effect of administering IV midazolam on PONV. This meta-analysis included 12 randomized controlled trials (n = 841) of adults undergoing a variety of surgical procedures that investigated the effect of both preoperative and intraoperative IV midazolam on PONV in patients undergoing general anesthesia. Administration of IV midazolam was associated with significantly reduced PONV (risk ratio [RR] = 0.55; 95% confidence interval [CI], 0.43-0.70), nausea (RR = 0.62; 95% CI, 0.40-0.94), vomiting (RR = 0.61; 95% CI, 0.45-0.82), and rescue antiemetic administration (RR = 0.49; 95% CI, 0.37-0.65) within 24 hours. Individual subgroup analyses of trials excluding the use of thiopental for induction, trials of either female sex or high-risk surgery, trials involving nitrous oxide maintenance, and trials using midazolam in combination with known antiemetics all yielded similar reductions in PONV end points within 24 hours of surgery. Administration of preoperative or intraoperative IV midazolam is associated with a significant decrease in overall PONV, nausea, vomiting, and rescue antiemetic use. Providers may consider the administration of IV midazolam as part of a multimodal approach in preventing PONV.

Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Background: Spinal anaesthesia for caesarian section is associated with hypotension, bradycardia, and nausea and vomiting. The study was done to evaluate the safety and efficacy of sub hypnotic dose of midazolam in prevention of intraoperative complication of caesarian section under spinal anaesthesia. Methods: In this study one group of women (N=250) received midazolam 0.02 mg /kg bolus immediately after delivery of baby and 0.01 mg/kg half hourly. Equal number of women who received placebo was taken as control group. Intraoperative emetic episodes, scores of sedation and mephentermine consumption were recorded. Results: Proportions of intraoperative nausea and vomiting were 12% and 51% in midazolam and control groups respectively (p<0.0001). To maintain the haemodynamic stability the requirement of mephentermine was significantly less in midazolam receiving women (p<0.0001). Twelve women of control group and no women of midazolam group required atropine. The number of patients that required tramadol 50 mg or more for chest pain, shoulder pain and headache was significantly lesser in midazolam group than in control group (p<0.001). Oxygen supplementation was necessary for more number of women of midazolam group (14%) than of control group (2.8%). Conclusions: Sub hypnotic doses of midazolam are safe and significantly reduce the incidence and severity of hypotension, bradycardia, nausea, vomiting and chest pain during caesarian section under spinal anaesthesia. Routine supplementation of oxygen may be necessary when midazolam is used.

The Effect of Intravenous Midazolam on Duration of Spinal Anesthesia

Background: A variety of systemic and intrathecal adjuvants to local anesthetics have been found to expand the duration and improve the quality of spinal block and decrease pain after surgeries. Objectives: The aim of this study was to evaluate the effect of the addition of midazolam to lidocaine for spinal anesthesia in lower abdomen and lower limb surgeries. Patients and Methods: In a prospective, randomized, double blind study, 36 patients aged 20 to 60 years, and American Society of Anesthesiologists (ASA) I or II, were randomly allocated to receive either intravenous midazolam (30 μg/kg) or placebo in spinal anesthesia. Level of sensory block, time to achieve maximum motor and sensory block, duration of sensory and motor block, recovery time, side effects, heart rate, blood pressure, arterial oxygen saturation and sedation score were measured and analyzed using the SPSS software version 15 by t-test and ANOVA. Data were considered significant at 0.05. Results: The motor block duration in midazolam and control group was 82.9 ± 27.3 and 59.1 ± 26.5, respectively (P = 0.01). However the duration of sensory block was not different between the two groups (P = 0.07). The median of sensory block level was at T8 and T10 in midazolam and control group (P = 0.02). Recovery time was more prolonged in the midazolam group (P = 0.002). Hemodynamic indices did not show any significant differences between the two groups. Conclusions: Addition of 30 μg/kg midazolam to lidocaine for spinal anesthesia improved duration of motor block and increased intraoperative sedation score without causing side effects in patients’ requiring lower abdomen and lower limb surgery.

470: Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

470: Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

470. Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

470. Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

Effect of Intravenous Midazolam on Duration of Spinal Anesthesia With Lidocain

0021 Comparing the effect of intravenous Midazolam with rectal sodium valproate in controlling of children with refractory status epileptics

0021 Comparing the effect of intravenous Midazolam with rectal sodium valproate in controlling of children with refractory status epileptics

Effects of Intravenous Midazolam and Diazepam on Patient Response, Percentage of Oxygen Saturation, and Hemodynamic Factors During Periodontal Surgery

The purpose of this double-masked study was to evaluate effects of intravenous sedation (IVS) using midazolam or diazepam during periodontal procedures on patient recall, psychomotor response, oxygen saturation, and hemodynamic factors. Seventeen patients received either two or three scheduled periodontal surgeries under IVS with midazolam, diazepam, or placebo control. Patients were monitored throughout the procedure for hemodynamic variables, percent oxygen saturation, level of recall of common objects presented at baseline, and psychomotor function via the perceptual speed test (PST). Fifteen patients completed the study with average titrated dosages of 3.3 and 12.1 mg for midazolam and diazepam, respectively. Within the limitations of the study, there were few differences observed between the drugs with regard to hemodynamic variables, oxygen saturation, and overall percentage of objects recalled by patients sedated with either drug. However, midazolam was found to cause a greater incidence of amnesia lasting up to 30 minutes when compared to placebo. Patients on diazepam required an average of 15 minutes longer to recover accuracy as measured by the PST. The results suggest that diazepam and midazolam each may have advantages for IVS. In procedures lasting over 45 minutes, diazepam appears to be more clinically advantageous including a wider margin of safety during titration and gradual recovery. Midazolam may be used for shorter procedures for faster onset of action, predictable amnesic effects, and relatively rapid recovery.

The Effect of Intravenous Midazolam or Atropine on Spinal Anesthesia-Induced Hypothermia in Geriatric Patients

Background: Perioperative hypothermia causes several complications, and in particular, is more hazardous in elderly patients. Hypothermia during regional anesthesia is often ignored. We investigated the effect of IV midazolam or atropine premedication on core hypothermia in geriatric patients undergoing transurethral predures via spinal anesthesia. Methods: Forty-five elderly (65-92 years old), ASA I or II patients about to undergo transurethral predures, such as prostate or bladder tumor removal were enrolled into this study. In all cases, standard spinal anesthesia was administered. The control group received no premedication, the midazolam group 0.02 mg/kg of midazolam, and the atropine group 5/kg of atropine, respectively just before spinal anesthesia. Core temperature was measured at the right tympanic membrane before anesthesia, at 10 and 30 min later, at the end of anesthesia, and 30 min after recovery from anesthesia. Results: Reduction of core temperature from the basal value, after 10 and 30 min of anesthesia, at the end of anesthesia, at 30 min after anesthesia during post-operative care unit in the control group were 0.31, 0.61, 0.5, and 0.42, respectively; 0.41, 0.61, 0.9, 0.65 in the midazolam group; and 0.15, 0.29, 0.37, 0.47 in the atropine group. When compared with no premedication, midazolam administration was assiated with a significantly lower core temperature at the end of anesthesia. Atropine administration was assiated with a significantly higher core temperature than the midazolam group after 10 and 30 min of anesthesia, and at the end of anesthesia, and the untreated control group after 10 and 30 min of anesthesia. Conclusions: IV premedicant midazolam decreased core temperature; however, atropine administration significantly reduced the magnitude of hypothermia assiated with spinal anesthesia in geriatric patients.

Effects of Intravenous Midazolam on the Work of Breathing

Midazolam at sedative doses induces an increase in upper airway resistance, but its effects on the work of breathing have not been established. The flow-resistive work of breathing and pulmonary resistance (RL) of eight healthy volunteers were measured, with either midazolam 0.1 mg/kg or placebo in a random order. Esophageal pressures were measured using a balloon-tipped catheter, airflow using a pneumotachograph. Total resistive work expressed per minute (WTOT) and per liter of ventilation (WTOT/VE), and their inspiratory (WI) and expiratory (WE) components were determined. No change was observed after placebo injection. Five minutes after midazolam injection, an increase was observed in WTOT (from 3 +/- 0.4 J/min [mean +/- SEM] at control to 6.3 +/- 1.1 J/min; P < 0.01) and in WTOT/VE (from 360 +/- 30 mJ/L at control to 1250 +/- 120 mJ/L; P < 0.01), involving both WI and WE components. An increased inspiratory RL was observed from 13.7 +/- 2.6 cm H2O.L-1.s-1 at control to 32.8 +/- 3.9 cm H2O.L-1.s-1 after midazolam. Changes in inspiratory RL were correlated to changes in WI and WI/VE (r = 0.574, P < 0.001; and r = 0.762, P < 0.001, respectively). Our results suggest that airway obstruction plays a major role in the increased work of breathing observed during sedation with midazolam.

The use of midazolam for persistent postoperative nausea and vomiting.

The effect of intravenous midazolam on persistent postoperative nausea and vomiting (PONV) was compared to placebo in a prospective randomized double-blind study. Twenty patients aged 18 to 82 years with persistent PONV resistant to standard anti-emetics and present for greater than six hours were randomized to receive either an intravenous infusion of midazolam 1.0 mg/h or placebo. Nausea (P = 0.04), vomiting (P = 0.02) and the use of rescue anti-emetics (P = 0.003) were significantly less in the midazolam group. We conclude that low-dose intravenous infusion of midazolam significantly reduces persistent PONV.

An investigation of the effect of midazolam on the pain experience

In a randomised, double-blind, cross-over study on 20 healthy human volunteers, the effect of intravenous midazolam on pain tolerance using the ‘submaximum effort tourniquet technique’ is described. Intravenous midazolam administered in conscious sedation doses was found to significantly reduce the affective and motivational component of the pain experience.

Gamma-aminobutyric acid type A receptor blockade at the intermediate area of the ventral surface of the medulla counteracts the cardiorespiratory depression produced by intravenous midazolam.

Intravenous administration of midazolam (2 mg/kg) to 8 pentobarbital-anesthetized cats produced a significant decrease in minute ventilation, tidal volume, blood pressure and heart rate. Treatment with the gamma-aminobutyric acid (GABA) type A receptor antagonist bicuculline (10 micrograms/side) at the intermediate area of the ventral surface of the medulla (VSM) oblongata completely reversed the cardiorespiratory depressant effects of intravenous midazolam. In contrast, treatment with bicuculline at the same area failed to counteract the respiratory depressant effects of intravenous morphine (1 mg/kg). We conclude that the cardiorespiratory depressant effects of intravenously administered midazolam are due to enhancement of GABAergic transmission at the intermediate area of the VSM.