Abstract
Anesthesia and Pain Medicine. 2003 Dec. 7(4): 155-159 ⓒ Korean Society for Intravenous Anesthesia |
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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 |
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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. |
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Key words : Conscious sedation, midazolam, propofol, regional anesthesia |
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