Titre
Midazolam premedication and thiopental induction of anaesthesia: interactions at multiple end-points
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Wilder-Smith, O. H.
Auteure/Auteur
Ravussin, P. A.
Auteure/Auteur
Decosterd, L. A.
Auteure/Auteur
Despland, P. A.
Auteure/Auteur
Bissonnette, B.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0007-0912
Statut éditorial
Publié
Date de publication
1999-10
Volume
83
Numéro
4
Première page
590
Dernière page/numéro d’article
5
Langue
anglais
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Oct
Résumé
We have studied the effects of midazolam premedication on multiple anaesthetic end-points (hypnotic, loss of verbal contact (LVC); motor, dropping an infusion flex or bag (DF); analgesic, loss of reaction to painful stimulation (LRP); and EEG, attainment of burst suppression (BUR)) during induction by slow thiopental infusion at a rate of 55 mg kg-1 h-1. Patients received midazolam 0.05 mg kg-1 i.v. (group TM, n = 12) or no midazolam (group T0, n = 13). ED50 and ED95 values and group medians for times and doses at the end-points were measured. Midazolam premedication reduced significantly thiopental ED50 and ED95 values at all end-points (exception for ED95 for BUR). Potentiation was greatest for the motor end-point (dropping the infusion bag (DF)) (ED95 +52%, ED50 +23%, median +39%), and smallest for painful stimulation (LRP) (median +18%; ED50 +13%). For LRP and DF, premedication was associated with significant, non-parallel increases in the slope of the thiopental dose-response curves, resulting in marked potency ratio changes from ED50 to ED95 (LRP +31%, DF +29%). There were no such increases for LVC or BUR. The interaction between midazolam and thiopental varied with the anaesthetic end-point and may also depend on the dose of thiopental. Our data suggest that the mechanism of interaction between midazolam premedication and thiopental was different for motor effects or analgesia (DF, LRP) compared with hypnotic effects or cortical depression (LVC, BUR), in agreement with the different central nervous system substrates underlying these distinct anaesthetic end-points.
Sujets
PID Serval
serval:BIB_82813762066F
PMID
Open Access
Oui
Date de création
2008-01-25T09:51:16.838Z
Date de création dans IRIS
2025-05-21T04:43:12Z
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Nom
REF.pdf
Version du manuscrit
published
Taille
131.19 KB
Format
Adobe PDF
PID Serval
serval:BIB_82813762066F.P001
URN
urn:nbn:ch:serval-BIB_82813762066F2
Somme de contrôle
(MD5):c983203b116e367b59862754a8f4c412