This study was undertken to estimate the induction time, hemodynamic responses and local venous complications after intravenous administration of the midazolam, the water-soluble benzodiazepine derivative, comparing with those of the thipental, as an induction agent. Sixty ASA Class I or II surgical patients were divided into two groups: I and II, and were given 5 mg/kg thiopental sodium and 0.15 mg/kg midazolam hydrochloride, respectively. The results obtained were as follows; 1) The induction timeQoss of palpebral reflex) of the group II(88.7+/-41.8 seconds)was longer than those of the group I (19.5+/-3.7 seeonds). 2) The magnitude of fall in the systolic blood presure, 1 and 2 minute after intravenous administration of the induction agents observed in the group II was smaller than those observed in the group I compared with the pre-induction valuea But other parameters did not change significantly compsred with the pre-induction values in both groups. 3) In five patients of the group I, they complained of pain on the injection, but no patient of the group II complained of it. There was no statistically significant difference in the incidence of the postoperative local venous complications on the injection sites such as thrombosis or phlebitis between both groups.
Administration, Intravenous ; Benzodiazepines ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Phlebitis ; Thiopental* ; Thrombosis

This study was undertken to estimate the induction time, hemodynamic responses and local venous complications after intravenous administration of the midazolam, the water-soluble benzodiazepine derivative, comparing with those of the thipental, as an induction agent. Sixty ASA Class I or II surgical patients were divided into two groups: I and II, and were given 5 mg/kg thiopental sodium and 0.15 mg/kg midazolam hydrochloride, respectively. The results obtained were as follows; 1) The induction timeQoss of palpebral reflex) of the group II(88.7+/-41.8 seconds)was longer than those of the group I (19.5+/-3.7 seeonds). 2) The magnitude of fall in the systolic blood presure, 1 and 2 minute after intravenous administration of the induction agents observed in the group II was smaller than those observed in the group I compared with the pre-induction valuea But other parameters did not change significantly compsred with the pre-induction values in both groups. 3) In five patients of the group I, they complained of pain on the injection, but no patient of the group II complained of it. There was no statistically significant difference in the incidence of the postoperative local venous complications on the injection sites such as thrombosis or phlebitis between both groups.
Administration, Intravenous ; Benzodiazepines ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Phlebitis ; Thiopental* ; Thrombosis

OBJECTIVE: To explore the safety and the efficacy of two-stage administration sedation method (with propofol plus midazolam) in the analgesia gastroscopy for hypoxia predisposed patients. METHODS: Sixty-four hypoxia predisposed patients (with snore or expectoration) were divided into two groups and received sedation respectively with two-stage administration method and routine continuum administration method before gastroscopy. We analyzed the alteration of SBP, DBP, SpO2, sedation level, the degree of pharyngeal malaise, recovery time, dose of propofol,the lethe degree of upset, and procedure of gastroscopy to evaluate the safety and the efficacy of the two methods in the analgesia gastroscopy for hypoxia predisposed patients. RESULTS: Compared with routine continuum administration sedation method, two-stage administration sedation method had little influence on SpO2, so it reduced the accident of respiratory arrest (P < 0.01). The gastroscopy could be achieved at the lower sedation level with two stage administration method (P <0.01), so that the recovery time was shortened (P < 0.01). The degree of pharyngeal malaise in the patients with two-stage administration sedation method was higher than that of patients with routine continuum administrationsedation method (P < 0.01), and the dose of propofol used for sedation decreased (P < 0.01). While the lethe degree of gastroscopy upset and alteration of SBP, DBP were rated similarly in both groups (P > 0.05), and the lethe degree of gastroscopy procedure in two-stage administration method group was significantly lower than that of routine continuum adminis- tration method group (P <0.01). CONCLUSION The two-stage administration sedation method is a new effective and safe sedation method for gastroscopy in the hypoxia predisposed patients.
Adult ; Analgesia ; Female ; Gastroscopy ; methods ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage

OBJECTIVETo compare the efficacy and safety of midazolam combined with fentanyl and propofol combined with fentanyl as conscious sedation in oocyte retrieval of in vitro fertilization and embryo transplantation (IVF-ET).

METHODSEighty patients receiving IVE-ET were randomly divided into midazolam combined with fentanyl group (midazolam group) and propofol combined with fentanyl group (propofol group). Antalgic effects, circulation status (blood pressure, heart rate), respiration status (rate, oxygen saturation and respiration depression) during operation, nausea and vomiting, and amnestic effects after operation were compared.

RESULTNo differences of antalgic effects and circulation status between two groups were observed. Percentages of respiration depression,vomiting and amnesia of midazolam group were 5.0 %, 10.0 % and 25%, respectively, and those of propofol group were 25%, 27.5% and 7.5%, respectively, which had statistical significance.

CONCLUSIONAs conscious sedation, midazolam combined with fentanyl is better than propofol combined with fentanyl in oocyte retrieval of IVF-ET.

Adult ; Anesthetics, Combined ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Fertilization in Vitro ; Humans ; Midazolam ; administration & dosage ; Oocyte Retrieval ; methods ; Propofol ; administration & dosage

BACKGROUND: Careful sedation is needed for cataract operation that requires absolute cooperation of elderly patients. Patient-controlled sedation (PCS) allows patients themselves change the dose of sedatives along with their need. The goal of this study was to find out midazolam PCS could achieve an adequate sedation without complications during cataract surgery and the differences of patients who needed PCS or not. METHODS: PCS with midazolam was applied to 33 patients undergoing cataract surgery using retrobulbar block (midazolam, bolus 0.5 mg, lock out interval 3 minutes, 1 hour limit 4.5 mg). PCS pump was given to patients 30 min before retrobular block. And patients themselves decided to use or not to use PCS after full explanation on PCS. Sedation score, visual analogue scale of anxiety, cognitive function, side effects and satisfaction of PCS were measured. RESULTS: PCS users were 22 (67%). Mean midazolam dosage of PCS users was 2.03 mg. Preoperative and intraoperative anxiety score were 40.2 mm and 13.0 mm in PCS users and 15.5 mm and 21.8 mm in non-users. The difference between PCS users and non-users was only preoperative anxiety levels. Age, sex, weight, education levels, previous cataract surgery, preoperative desired sedation levels did not influence on the PCS using. There was positive correlation of midazolam doses with only preoperative anxiety levels. 76% of surgeons and 85% of patients were satisfied with PCS but 7 patients showed involuntary movement. Cognitive functions and discharge time were not influenced by PCS. CONCLUSIONS: Although patients and surgeons were satisfied with the midazolam PCS, 33% of patients did not need PCS and deep sedation with involuntary movement that could bring surgical complications was resulted in some PCS users. We conclude that PCS for cataract surgery would be safer when it is administered under careful supervision of anesthesiologist.
Aged ; Anxiety ; Cataract* ; Deep Sedation ; Dyskinesias ; Education ; Humans ; Hypnotics and Sedatives ; Midazolam* ; Organization and Administration

BACKGROUND: The objectives of this study were to assess propofol as sedative agents for colonoscopy in the safety and efficacy, compared with midazolam plus meperidine. METHODS: 120 patients undergoing colonoscopy in a prospective study were randomly assigned to one of three medication regimens. Patients in group A (n=42) received i.v. 25 mg of meperidine and 2.5 mg of midazolam. Patients in group B (n=41) received i.v. a median dose of 96.59 mg of propofol (range 40-180) and patients in group C (n=37) received i.v. 25 mg of meperidine and a median dose of 77.03 mg of propofol (range 40-150), administered by a nurse with endoscopist supervision. Endpoints were patient satisfaction, procedure and recovery times and complications. RESULTS: The mean time to sedation was much faster in 2 groups using propofol (group A: 152+/-105.9 sec, group B: 52.9+/-46.5 sec, group C: 56+/-63.7sec; p<0.001). The mean time to reach the cecum was not different among the 3 groups. There were total 3 episodes of oxygen desaturation to <90%, as one in each group, but the patients were spontaneously recovered with only increasing O2 concentration and arousal. Patients in group C expressed better overall mean satisfaction than patients in group A (p=0.049), but difference was not found between group A and group B. The amnestic effect was better in two groups using propofol than group A (p=0.017) The mean dose of propofol was lower in the patients who received propofol combined with low dose of meperidine than those with propofol only (77.03 mg vs 96.59 mg, p=0.009). CONCLUSION: Nurse-administered propofol sedation with endoscopist supervision is believed to be safe and useful for colonoscopy with careful monitoring.
Arousal ; Cecum ; Colonoscopy ; Conscious Sedation* ; Humans ; Meperidine ; Midazolam ; Organization and Administration ; Oxygen ; Patient Satisfaction ; Propofol* ; Prospective Studies*

This study was performed to evaluate the induction time, hemodynamic responses and local venous complications after intravenous induction with midazolam, comparing with those after intravenous induction with thiopental. Sixty adult surgical patients received either 5 mg/kg thiopental sodium(group I) or 0.2 mg/kg midazolam hydrochloride(group II) as an induction agent. The results were as follows. 1) The induction time(loss of palpebral reflex) of the group II(68.2+/-21.5 sec) was significantly longer than those of group I(29.6+/-8.3 sec) 2) The magnitude of rises in the systolic blood pressure, 1 and 2 minute after intravenous administration of induction agent, of group II were significantly smaller than those of group I. 3) The magnitude of rises in the diastolic blood pressure, 2 minute after intravenous administration of induction agent,of group II were significantly smaller than those of group L 4) The magnitude of rises in the pulse rate, 1 and 2 minute after intravenous administration of induction agent, of group II was not significantly differ from those of group I. 5) In three patients of the group I complained of pain during injection, but no patients of the group II complained of pain. There was no significant difference in the incidence of the postoperative local venous complication.
Administration, Intravenous ; Adult ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Thiopental*

BACKGROUND AND OBJECTIVES: Sleep endoscopy is a valuable modality for an anatomical assessment in patients with snoring and obstructive apnea. The aims of this study is to observe the anatomical obstructive site using sleep endoscopy and to compare the sleep endoscopic findings and the results of the Mueller maneuver in clinical setting. SUBJECTS AND METHOD: Thirty patients with obstructive sleep apnea syndrome underwent sleep endoscopy. After intravenous administration of midazolam, obstructive events were observed. The levels of obstruction were classified as palatal, palatal with tonsil and palatal with tongue base. Obstruction was defined when the site was collapsed more than 50% compared with normal respiration during the apneic episode. RESULTS: On sleep endoscopy, retropalatal obstruction was observed in 14 patients (47%). Obstruction in the retropalatal area combined with the tonsillar area was found in 9 patients (30%). Obstruction in the retropalatal area combined with the tongue base area was found in 7 patients (23%). However, the results of Mueller maneuver showed retropalatal obstruction in 19 patients (63%), obstruction in the retropalatal with tonsillar area in 9 patients (30%) and obstruction in the retropalatal with tongue base area in 2 patients (7%). CONCLUSION: Sleep endoscopy is a useful modality to assess the accurate anatomical site of obstruction during sleep state and provide information useful in planning of further treatment.
Administration, Intravenous ; Apnea ; Endoscopy* ; Humans ; Midazolam ; Palatine Tonsil ; Respiration ; Sleep Apnea, Obstructive* ; Snoring ; Tongue

Adolescent ; Adult ; Anesthesia ; Child ; Evoked Potentials, Auditory ; Humans ; Midazolam ; pharmacology ; Monitoring, Intraoperative ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Spine ; surgery

OBJECTIVETo observe the effectiveness of conscious sedation with midazolam, propofol and sufentanil for patients in plastic surgery.

METHODS81 patients, scheduled for plastic surgery, were randomly selected to receive conscious sedation with midazolam 0.05 mg x kg(-1) and sufentanil 0.1 microg x kg(-1) intravenously, following by a continuous infusion of midazolam-propofol-sufentanil combination (midazolam 5 mg + propofol 200 mg + sufentanil 10 microg, a total of 23 ml). The initial infusion rate was 0.2 ml x kg(-1) x h(-1), and was adjusted (in 20% of initial infusion rate increment) to maintain OAA/S score as 11 during the operation. The patients' vital signs, discomfort and level of sedation were evaluated at 5 to 10 min intervals until the end of the surgery. The complications (i. e. anoxemia, apnea, restlessness, nausea and vomiting), anesthesia duration and drug consumption were recorded. The drug infusion was discontinued at 5 - 10 min before the end of the surgical procedure. On the first postoperative day, patients were asked to rate their satisfaction with the anesthetic management and whether they would choose to receive the same anesthetic technique if necessary in the future.

RESULTSThe OAA/S score decreased from 20.0 +/- 0 to 11.9 +/- 2.6 after midazolam and sufentanil IV (P < 0.05), and was maintained as 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score returned to 16.0 +/- 2.2, which was also lower significantly compared with baseline value (P < 0.05). The induction of sedation produced a significant decrease in SBP and DBP (P < 0.05) and no significant changes in heart rate (P > 0.05). At the end of the procedure, SBP, DBP and HR returned to the baseline value. The anoxemia happened in 11 cases, apnea in 5 cases and restlessness in 2. No nausea and vomiting occurred. The anesthesia duration and consumption of midazolam, propofol and sufentanil were (101.1 +/- 42.5) min, (8.4 +/- 3.7) mg, (189.1 +/- 88.7) mg and (18.2 +/- 5.6) microg respectively. In an interview on the first postoperative day, 96% (78/ 81) of the patients were satisfied with their anesthesia and were willing to receive the same anesthetic technique if necessary in the future.

CONCLUSIONConscious sedation with midazolam, propofol and sufentanil is an effective anesthetic technique for patients in plastic surgery.

Adolescent ; Adult ; Conscious Sedation ; methods ; Female ; Humans ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage ; Sufentanil ; administration & dosage ; Surgery, Plastic ; Young Adult