The Effect of Intravenous Midazolam on Duration of Spinal Anesthesia

Rezvani, Mehran; Alikhani, Ameneh; Golparvar, Mohammad; Amini, Zahra

doi:10.17795/semj21586

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…compared the effects of intravenous administration of diazepam and midazolam, as anesthesia prodrugs, on preoperative SpO 2 and the results showed that both drugs reduced SpO 2 , but the effects of midazolam were greater, as t -test indicated a significant difference between the two groups during the first 5 min after the prodrug administration. [19]…”

Section: Discussionmentioning

confidence: 99%

Prevention of Cognitive Dysfunction after Cataract Surgery with Intravenous Administration of Midazolam and Dexmedetomidine in Elderly Patients Undergoing Cataract Surgery

2019

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Background: This study aimed to compare the effects of preoperative administration of midazolam and dexmedetomidine on cognitive dysfunction prevention after cataract surgery. Materials and Methods: This research was a double-blind controlled clinical trial. In this study, 150 candidates for cataract surgery under general anesthesia, over 65 years, and similar to American Society of Anesthesiologists I and II characteristics were selected as the sample and randomly assigned to three groups. Participants of these three groups were treated with 0.1 mg/kg of midazolam, 1 μg/kg of dexmedetomidine, and the same volume of normal saline (control), respectively. Hemodynamic parameters and cognitive dysfunction score of the participants were measured using the Mini-Mental State Examination (MMSE) before the surgery, 24 h and 1 week after the surgery. Results: An evaluation of hemodynamic parameters before anesthesia up to 24 h after the surgery showed no significant difference between the midazolam, dexmedetomidine, and control groups in terms of systolic and diastolic blood pressure, heart rate, and blood oxygen saturation ( P > 0.05). In addition, there was no statistically significant difference between the midazolam and dexmedetomidine groups in the MMSE score before the surgery and 24 h and 1 week after that ( P > 0.05). However, there was a significant difference between these two groups and control ( P < 0.05). Conclusion: There was no significant difference between midazolam and dexmedetomidine in reducing postoperative cognitive dysfunction (POCD). However, there is a significant difference between these two groups and control. Hence, either midazolam or dexmedetomidine can be prescribed to reduce POCD in cataract surgeries.

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Section: Discussionmentioning

confidence: 99%

Prevention of Cognitive Dysfunction after Cataract Surgery with Intravenous Administration of Midazolam and Dexmedetomidine in Elderly Patients Undergoing Cataract Surgery

2019

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“…Furthermore, a physiological saline group was not included in the present study. Talakoub R, et al reported that 0.03 mg/kg of intravenous midazolam significantly extended the duration of the motor blockade of lidocaine spinal anesthesia over that with saline [24]. Therefore, the addition of a saline group as a placebo may be preferable for observing the effects of dexmedetomidine itself on the duration of spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Effects of Continuous Intravenous Infusion of Dexmedetomidine on the Duration of Spinal Anesthesia: A Prospective, Double-Blind, Randomized, Controlled Trial

Watanabe¹,

Kanazawa²,

Suzuki³

2018

OJAnes

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Background: Spinal anesthesia with sedation is a common anesthetic technique in infraumbilical surgeries. Dexmedetomidine has been widely used as a sedative during spinal anesthesia, and is recognized as an adjuvant that prolongs the duration of spinal anesthesia. We compared the effects of a continuous intravenous infusion of dexmedetomidine to provide intraoperative sedation on the duration of sensory and motor blockade induced by spinal anesthesia, with those of midazolam. Methods: A double-blind randomized controlled trial was performed on 40 patients, aged between 20 and 75 years, who requested intraoperative sedation, and were classified as American Society of Anesthesiologists (ASA) physical status I-II, and underwent elective surgeries under spinal anesthesia. After spinal anesthesia with 13 mg (2.6 ml) of 0.5% hyperbaric bupivacaine, patients were randomized to receive intravenous dexmedetomidine 3 μg/kg/h for 10 mins followed by an infusion of 0.5 μg/kg/h (Group D), or intravenous midazolam 0.15 mg/kg/h for 10 mins followed by an infusion of 0.025 mg/kg/h (Group M). Sedation was titrated to Observer's Assessment of Alertness/Sedation (OAA/S) score of 3. Sensory and motor blockade was evaluated using the pinprick test and modified Bromage scale, respectively. Results: The time taken to achieve OAA/S score 3 was similar in the two groups. The maximal level of sensory blockade was 5.3 ± 1.3 min in group D and 4.1 ± 1.5 in group M (P = 0.03). No significant differences were observed in the time taken to achieve the maximal level or the two-segment regression time of sensory blockade between the two groups. The time to sensory regression to the L2 level was significantly longer in group D than in group M (234.6 ± 78.1 mins versus 172.4 ± 41.

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“…9,12,13 Kaya et al concluded that IV Dexmedetomidine and not Midazolam prolongs the duration of SA and Talakoub et al found no effect of Midazolam on duration of sensory block. 14,15 Our study also showed that duration of analgesia was Dexmedetomidine as compared to Midazolam. [9][10][11][12][13][14][15][16] Similar studies by some authors have shown prolongation of sensory anaesthesia and post-operative analgesia in patients receiving intravenous sedation mainly Dexmedetomidine.…”

Section: Discussionmentioning

confidence: 67%

“…14,15 Our study also showed that duration of analgesia was Dexmedetomidine as compared to Midazolam. [9][10][11][12][13][14][15][16] Similar studies by some authors have shown prolongation of sensory anaesthesia and post-operative analgesia in patients receiving intravenous sedation mainly Dexmedetomidine. [12][13][14] We found that maximum patients (89.95%) receiving Dexmedetomidine had a RSS score of 3 after sedation.…”

Section: Discussionmentioning

confidence: 67%

“…12 Among complications many authors mentioned a higher incidence of bradycardia in Dexmedetomidine sedation and incidence of hypotension in Propofol and Midazolam. [10][11][12][13][14][15][16] Patki et al also showed the absence of clinically relevant bradycardia and hypotension. 11 Thus, sedation was associated with good patient satisfaction and stable hemodynamics and also prolonged post-operative analgesia.…”

Section: Discussionmentioning

confidence: 99%

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Current Sedation Practices in Procedures under Spinal Anaesthesia (SA)

Harde¹,

Gujjar²

2019

IJCMR

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Introduction: Peri-operative anxiety and stress associated with procedures under Spinal anaesthesia (SA) is common and sedation may help improving compliance of the patient and quality of SA. There is no standard sedation protocol for SA. Study aimed to observe the various sedation protocols practiced in our institute during SA with regard to drugs used and their dosages, sedation levels, effect on the duration of SA and to assess the patient satisfaction level. Material and methods:This was a prospective observational study comprised of patients undergoing elective surgeries under SA. IV sedation was given as per the attending anaesthesiologist's discretion after SA. We noted hemodynamic parameters, RSS, two-dermatomal regression time, Patient satisfaction scores etc. Epi Info 7.2 software was used for statistical analysis. Results Total 500 patients received Dexmedetomidine (189), Midazolam (301) and Propofol (10) as IV sedation. Mean time required for regression of two-dermatomal sensory levels and for rescue analgesia requirement was prolonged in Dexmedetomidine (121.64, 203.75 mins resp.), as compared to Midazolam and Propofol. Mean Ramsay Sedation Score (2.4-3) and Patient satisfaction scores (6-7.5) were comparable in all the drugs. Hemodynamic parameters were stable and comparable. No hypotension, respiratory depression seen except bradycardia (HR<50) noted in 4 patients of Dexmedetomidine. Conclusion: Drugs used for sedation in 500 patients were Dexmedetomidine, Midazolam and Propofol. All the drugs provided optimum sedation without respiratory depression with stable hemodynamics and good patient satisfaction. In addition, Dexmedetomidine increased durations of sensory anaesthesia and post-operative analgesia.

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The Effect of Intravenous Midazolam on Duration of Spinal Anesthesia

Cited by 6 publications

References 23 publications

Prevention of Cognitive Dysfunction after Cataract Surgery with Intravenous Administration of Midazolam and Dexmedetomidine in Elderly Patients Undergoing Cataract Surgery

Prevention of Cognitive Dysfunction after Cataract Surgery with Intravenous Administration of Midazolam and Dexmedetomidine in Elderly Patients Undergoing Cataract Surgery

Effects of Continuous Intravenous Infusion of Dexmedetomidine on the Duration of Spinal Anesthesia: A Prospective, Double-Blind, Randomized, Controlled Trial

Current Sedation Practices in Procedures under Spinal Anaesthesia (SA)

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