The effect of co‐induction with midazolam upon recovery from propofol infusion anaesthesia

Abstract

We studied tracheal intubation conditions produced by the muscle relaxant, cisatracurium, following induction of anaesthesia with fentanyl (2 mg.kg ÿ 1) and thiopentone (6 mg.kg ÿ 1). Sixty patients were randomly assigned to receive cisatracurium in a single bolus dose of either 0.15 or 0.20 mg.kg ÿ 1. Tracheal intubation was commenced 120 s after injection of the relaxant. The mean (SD) time taken to achieve intubation was significantly shorter in the 0.20 mg.kg ÿ 1 group (137 (16) s) than the 0.15 mg.kg ÿ 1 group (149 (12) s; p < 0:05). The intubating conditions were better after the larger dose. Our results suggest that when anaesthesia is induced using thiopentone, a dose of 0.20 mg.kg ÿ 1 of cisatracurium is recommended to ensure satisfactory intubating conditions. Cisatracurium is an isomer of atracurium. It is a highly potent, nondepolarising muscle relaxant (ED 95 estimated to be 50 mg.kg ÿ 1) which does not provoke histamine release [1]. Doses of 3 × or 4 × ED 95 of cisatracurium produce satisfactory intubating conditions when propofol is used as the induction agent [2-4]. Since propofol itself can provide satisfactory intubating conditions [5, 6] it may affect the quality of the intubating conditions produced by a muscle relaxant. We studied the intubating conditions produced by two different doses of cisatracurium after induction of anaesthesia with thiopentone.

A comparison between midazolam co‐induction and propofol predosing for the induction of anaesthesia in the elderly

“…We were unable to demonstrate any difference in adverse events such as coughing, laryngospasm or involuntary movements between groups. There is conflicting data in the literature with respect to time to discharge, which reflects differences in study design [15, 16].…”

Laryngeal mask insertion using thiopental and low dose atracurium: A comparison with propofol

“…7 However, topical lidocaine can be unpleasant to taste and may produce upper airway obstruction, s Recovery from anesthesia can be delayed with midazolam co-induction. 9 The aim of our study was to determine whether the use of thiopental in combination with low dose atracurium provided LMA insertion conditions comparable with those after propofol.…”

The effect of midazolam-thiopental coinduction on recovery in minor surgery

“…Djaiani and Ribes-Pastor [12] reported that the addition of midazolam (0.05 mg·kg Ϫ1 ) to propofol induction delayed the time of discharge from the hospital. In another study, Tighe and Warner [15] investigated the effect of midazolam-propofol coinduction on psychomotor recovery by using psychomotor tests. Coinduction with midazolam reduced psychomotor recovery in the immediate postoperative phase following propofol infusion anesthesia.…”