Recovery of postural stability following conscious sedation with midazolam in the elderly

Abstract

In the recovery from sedation, elderly patients had more difficulty in acquiring postural adjustment during movement than in maintaining a standing posture. If the dose is carefully administered, however, even elderly patients might be able to return home 2 h after midazolam administration, as could the younger patients.

Correlation between precise and simple tests in recovery of dynamic balance function after intravenous sedation with midazolam in the elderly

“…Excessive sedation, airway obstruction, and respiratory failure may occur in elderly patients when the same dose of a benzodiazepine sedative as that needed for younger patients is administered, because the pharmacodynamics and/or pharmacokinetics of these drugs are different for the elderly and younger persons [18,19].Therefore, careful titration is needed to achieve an optimal sedation level in intravenous sedation, especially for the elderly [20,21]. On this occasion, it is desirable to evaluate the sedation level objectively.…”

Assessment of the recovery of dynamic balance after intravenous sedation with midazolam

“…The subjects were asked to keep the platform horizontal for 20 s. The index of the degrees of platform tilting in all directions from the horizontal line during the test was expressed as the stability index. As CSP, static stance sway tests were performed using a Balance Master System (NeuroCom International, Clackamas, OR, USA) by the previously reported method [6]. Static stance sway in the standing position was observed under three conditions (with eyes open, with eyes closed, and with visual feedback that allows minor adjustments of the position of the center of gravity).…”

“…However, some studies have suggested low reliability of both tests [4,5]. Therefore, studies by computerized static posturography (CSP) have been performed to assess balance function more objectively and precisely [4][5][6]. Although computerized dynamic posturography (CDP) with movement of the center of gravity is more appropriate than CSP to determine whether safe discharge by walking is possible, there have been only a few studies that evaluated the recovery process of dynamic balance by CDP in comparison with CSP [7][8][9], and there have been no studies in which detailed evaluation was performed at short intervals.…”

Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo

“…Sin embargo, la recuperación total psicomotora es más lenta en el segundo grupo, y puede tardar hasta 120 min luego de mantener a los pacientes sedados con BIS de 60 a 70 305 . Los tiempos de recuperación de la estabilidad postural en ancianos respecto a personas jóvenes son más lentos y pueden tardar hasta 120 min 306 .…”