The cardiovascular effects of midazolam co-induction to propofol for induction in aged patients.
10.4097/kjae.2012.62.6.536
- Author:
Young Soo LIM
1
;
Dong Hee KANG
;
Se Hwan KIM
;
Tae Ho JANG
;
Kyung Han KIM
;
Sie Jeong RYU
;
Soo Bong YU
;
Doo Sik KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea. kds0728md@gmail.com
- Publication Type:Original Article
- Keywords:
Aged;
Cardiovascular system;
Drug synergism;
Midazolam;
Propofol
- MeSH:
Aged;
Androstanols;
Anesthesia, General;
Blood Pressure;
Cardiovascular System;
Drug Synergism;
Heart Rate;
Humans;
Intubation;
Midazolam;
Piperidines;
Propofol;
Unconsciousness
- From:Korean Journal of Anesthesiology
2012;62(6):536-542
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to investigate whether a small dose of midazolam and lessening the propofol dosage could prevent cardiovascular change at tracheal intubation for induction in aged patients. METHODS: Eighty patients over 65 years (ASA physical status 1, 2) scheduled for elective surgery received general anesthesia with remifentanil and propofol or midazolam. Patients in group P (n = 40) were induced with 0.9% NaCl 0.03 ml/kg, propofol 1. 2 mg/kg and remifentanil. Patients in group MP (n = 40) were induced with midazolam 0.03 mg/kg, propofol 0.8 mg/kg and remifentanil. The time taken to reach loss of consciousness (LOC) and the value of bispectral index score (BIS) at LOC were recorded. After LOC, 0.8 mg/kg of rocuronium was given and tracheal intubation was performed. The mean blood pressure (MBP) and heart rate (HR) were recorded before induction as the base value, before intubation, immediately post-intubation and 3 minutes after intubation. RESULTS: Compared with the base values, MBP at before intubation and 3 minutes after intubation was significantly decreased in group P and group MP (P < 0.05). Compared with group P, the decrease of MBP was significantly less at before intubation, immediately after intubation and 3 minutes after intubation in group MP (P < 0.05). The time taken to reach LOC was significantly decreased in group MP compared with that in group P (P < 0.05). There were no significant differences of HR at any time between the two groups. CONCLUSIONS: Co-induction with midazolam and propofol could prevent a marked BP decrease at tracheal intubation for induction in aged patients.
