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KMID : 1141320170320010036
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Kosin Medical Journal
2017 Volume.32 No. 1 p.36 ~ p.46
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Hemodynamic Effects of Co-administration of Midazolam during Anesthesia Induction with Propofol and Remifentanil in Hypertensive Patients
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Kim Ju-Deok
Kim Joo-Won
Kung His-Chiang
Kang Jun-Hong
Shin Hye-Young
Kim Doo-Sik
Ryu Sie-Jeong
Kim Kyung-Han
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Abstract
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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.
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KEYWORD
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Drug synergism, Hypertension, Intratracheal intubation, Midazolam, Propofol
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