Hemodynamic Effects of Co-administration of Midazolam during Anesthesia Induction with Propofol and Remifentanil in Hypertensive Patients.
- Author:
Ju Deok KIM
1
;
Joo Won KIM
;
His Chiang KUNG
;
Jun Hong KANG
;
Hye Young SHIN
;
Doo Sik KIM
;
Sie Jeong RYU
;
Kyung Han KIM
Author Information
- Publication Type:Original Article
- Keywords: Drug synergism; Hypertension; Intratracheal intubation; Midazolam; Propofol
- MeSH: Anesthesia*; Blood Pressure; Drug Synergism; Heart Rate; Hemodynamics*; Humans; Hypertension; Intubation; Intubation, Intratracheal; Midazolam*; Propofol*
- From:Kosin Medical Journal 2017;32(1):36-46
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVES: Propofol, midazolam and remifentanil are commonly used for clinical anesthesia. We compared the effects of midazolam-propofol-remifentanil and propofol-remifentanil on hemodynamic responses during anesthesia induction in hypertensive patients. METHODS: Seventy-six hypertensive patients with ASA II-III were assigned to receive midazolam-propofol (group MP; n = 38) or propofol (group P; n = 38). Anesthesia was induced with midazolam 0.03 mg/kg (group MP) or saline 0.03 ml/kg (group P). After two minutes, propofol 1.0 mg/kg (group MP) or 1.5 mg/kg (group P) i.v. bolus was administered. Simultaneously, 4 ng/ml of remifentanil target controlled infusion (TCI) was administered in both groups. Anesthesia was maintained using sevoflurane and 2 ng/ml of remifentanil TCI. Systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP) and heart rate (HR) were measured before induction, 2 min after midazolam or normal saline, 2 min after propofol, 1 min after rocuronium, and immediately, 1 min, 2 min, and 3 min after intubation. RESULTS: SBP, DBP, and MBP decreased after propofol administration and increased immediately after intubation in both groups (P < 0.05). After intubation, SBP, DBP, and MBP decreased more than baseline values in either group. Although the overall BP of Group P was lower than that of Group MP, there were no significant differences except for SBP at 2min after intubation (P < 0.05). HR was no significant difference in either group. CONCLUSION: Our results suggest that midazolam-propofol-remifentanil has similar hemodynamic effect with propofol-remifentanil during anesthesia induction in hypertensive patients.
