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KMID : 0356920120620060536
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Korean Journal of Anesthesiology
2012 Volume.62 No. 6 p.536 ~ p.542
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The cardiovascular effects of midazolam co-induction to propofol for induction in aged patients
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Lim Young-Soo
Kang Dong-Hee
Kim Se-Hwan
Jang Tae-Ho
Kim Kyung-Han
Ryu Sie-Jeong
Yu Soo-Bong
Kim Doo-Sik
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Abstract
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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.
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KEYWORD
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Aged, Cardiovascular system, Drug synergism, Midazolam, Propofol
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