Oral premedication with low dose midazolam modifies the immunological stress reaction after the setting of retrobulbar anaesthesia

Abstract

Background/aims: An acute immunological stress reaction was previously reported to occur after the painful setting of retrobulbar anaesthesia before intraocular surgery. This study was conducted to find out whether an oral low dose premedication with midazolam would modify the immunological stress reaction. Methods: 32 patients undergoing intraocular surgery using retrobulbar anaesthesia were included in a randomised, double blind trial. They received premedication with either 3.75 mg midazolam or placebo 30 minutes before the retrobulbar injection. Counts of leucocyte subpopulations, cardiovascular, and psychometric parameters were measured repetitively before and after the retrobulbar injection. Results: The numbers of leucocytes increased significantly in the placebo group after the setting of retrobulbar anaesthesia (before retrobulbar injection: 6687 (SD 1025) cells ×10

Effects of physical and chemical immobilization on hematologic and biochemical variables in captive brown brocket deer (Mazama gouazoubira)

“…However, increased cortisol concentration was described in a study of lambs subjected to physical restraint as not the only one of the factors capable of reducing lymphocyte function, once a possible interaction between catecholamine and cortisol concentrations can affect lymphocyte function 16 . Thus, the decreased lymphocyte counts observed in P2 may reflect an effect of oral premedication with midazolam by diminishing the release of catecholamines, as described in people, 17 even though the cortisol concentrations among protocols did not vary significantly. Also, neutrophil counts were not affected by oral midazolam, as described for people, although in the present study the degree of decrease in lymphocyte counts was small and likely has a negligible impact on clinical decision making.…”

Oral Medication With Diazepam or Midazolam Associated or Not With Clonidine for Oculoplastic Office Surgery Under Local Anesthesia

“…Although some authors have initiated surgery shortly after drug administration (20 minutes), 14 the mean time used is 35 minutes. 5,14,15,18,20 We waited 1 hour before taking the patient to the operating room. Most patients were already sedated when the procedures started, and we had no complaints about the surgery or the waiting time.…”

“…The benzodiazepines most frequently used are diazepam, 21,23-25 lorazepam, 16,19,23,27 and midazolam. 15,18,20 Midazolam is a short-acting benzodiazepine, which is frequently administered intravenously in anesthesia induction. When compared with diazepam, midazolam is more potent and has a shorter elimination half-time of 1.5 to 3 hours.…”

Verbessern intraven�ses Fentanyl oder Midazolam vor Durchf�hrung einer peripheren Regionalan�sthesie Patientenakzeptanz und Kooperativit�t bei der Katheteranlage?

“…Dennoch sollte der Patient dabei kooperativ bleiben, um unkontrollierte Bewegungen zu vermeiden, die v. a. dann auftreten, wenn der Patient plötzlich aus dem Schlaf erwacht. Neben subjektivem Unbehagen werden auch Blutdruckspitzen und Tachykardien beobachtet [6], und es konnte sogar der Nachweis erbracht werden, dass messbare immunologische Stressreaktionen auf die schmerzhafte Anlage einer Regionalanästhesie auftreten [3].…”

“…Studien zur medikamentösen Vorbereitung auf eine örtliche Betäubung wurden bisher vorwiegend an Patienten durchgeführt, die eine Retrobulbäranästhesie [3,4,5,6,9,10], eine Lokalanästhesie im Gesicht [2] oder eine Koronarangiographie [1] erhielten. Im Gegensatz zu zahlreichen Untersuchungen zur Analgosedierung während Operationen in Regionalanästhesie sind uns hingegen keine Studien bekannt, die die Effektivität einer Analgosedierung vor Anlage peripherer Regionalanästhesiekatheter mit einem Nervenstimulator untersucht haben.…”