Intravenous anesthesia

Abstract

Anesthesia and Pain Medicine. 2002 June 6(2): 60-65
ⓒ Korean Society for Intravenous Anesthesia
  
 
 
The Sedative Effect of Intravenous Midazolam in Patient-Controlled Sedation and Analgesia with Propofol and Fentanyl: A Comparison between Bolus Injection and Continuous Infusion
Won Kyoung Kwon, Hee Pyoung Park, Yong Seok Oh
Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea
 

BACKGROUND: Intravenous bolus administration of midazolam for premedication followed by patient- controlled sedation and analgesia (PCSA) often cause inadvertent oversedation in some patients. The purpose of this study was to evaluate the efficacy of midazolam added in the reservoir bag of PCSA device using propofol/fentanyl in patients undergoing endoscopic sinus surgery (ESS).
METHODS: 75 Subjects were randomly allocated to two groups. In group 1 (n = 35), midazolam 0.03 mg/kg intravenous bolus was administered prior to start PCSA, which regimen were composed of propofol 400 mg and fentanyl 200 microgram. Midazolam 2.5 mg was mixed in the reservoir bag of PCSA device in group 2 (n = 40). The PCSA was set at basal infusion rate 10 ml/hr, bolus dose 1 ml and lockout time 1 min. During surgery, we checked vital signs and sedation state. At the end of surgery, we assessed the degree of satisfaction about pain and anxiety relieving effects by using a questionnaire with a 1 to 10 scale.
RESULTS: There was no significant difference in the incidence of amnesia and the degree of satisfaction about pain and anxiety relieving effects between the two groups. The occurrence of sedation was significantly higher in group 1 compared to group 2 (P < 0.05), but the severity of sedation was not different between the two groups.
CONCLUSIONS: We concluded that midazolam added in the reservoir bag of PCSA device may be a useful method to relieve patient\'s anxiety and pain without excessive sedation for those undergoing ESS under local anesthesia.
 
Key words : Analgesia, patient-controlled analgesia, Hypnosis, patient-controlled sedation, Anesthetics, intravenous, propofol, midazolam, Analgesics, fentanyl
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