Intravenous anesthesia


Anesthesia and Pain Medicine. 2003 Dec. 7(4): 155-159
ⓒ Korean Society for Intravenous Anesthesia
The Effect of Midazolam Premedication for Conscious Sedation in Regional Anesthesia Patients
Bong Jin Kang, M.D., and Dong Hee Kim, M.D.
Department of Anesthesiology, College of Medicine, Dankook University, Cheon An, Korea

BACKGROUND: The aim of this study was to determine the effectiveness of midazolam premedication in conscious sedation using propofol target controlled sedation (TCI) for regional anesthesia patients.
METHODS: Forty patients scheduled to undergo spinal anesthesia with 0.5% hyperbaric bupivacaine 12 -18 mg or brachial plexus block with 0.375% ropivacaine 30 ml were divided into 2 groups. In premedication group (n = 20), midazolam 0.05 mg/kg were injected intravenously 30 min prior to start of operation. In control group (n = 20), there was no premedication. During the sedation, initial target concentration of propofol TCI was 1.0 mug/ml and the target concentration was adjusted in steps of 0.2 mug/ml to maintain an observer\'s assessment of alertness/sedation (OAA/S) scale of 3.
RESULTS: The mean (range) infusion rate and target concentration of propofol were significantly lower in premedication group (P < 0.05): 30.9 (18.9 -50.3) mug/kg/min and 0.7 (0.3 -1.5) mug/ml in premedication group, and 46.2 (21.5 -68.3) mug/kg/min and 1.2 (1.0 -1.8)mug/ml in control group. The incidences of recall of operation were significantly higher in control group (P < 0.05). Intraoperative inadequate sedation and involuntary movement were significantly lower in premedication group (P < 0.05).
CONCLUSIONS: With midazolam premedication, a satisfactory level of sedation and amnesia were achieved in conscious sedation using propofol TCI in regional anesthesia patients.
Key words : Conscious sedation, midazolam, propofol, regional anesthesia
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