Abstract:
:The clinical effects and pharmacokinetics of 24 h infusion of midazolam (MDZ) during major maxillofacial surgery and postoperative observation in an Intensive Care Unit (ICU) were studied in 20 patients. During anaesthesia, infusion of MDZ at 5 mg/h combined with 67% nitrous oxide, 1.8 (s.d. = 0.8) mg of fentanyl, and 26.5 (s.d. = 11.4) mg of vecuronium, adequately suppressed clinical responses to surgical nociceptive stimuli. Postoperatively, infusion of MDZ was continued in the ICU at 5 mg/h until 9 a.m. of the first postoperative day for sedation of the intubated but spontaneously breathing patients. The depth of sedation in the ICU was scored from 1-5 (1 = "awake and tense", 5 = "unable to communicate"). During infusion the sedation score decreased from 3.8 after ICU arrival to 2.2 at 8 a.m. of the first postoperative day. Neither ventilatory nor circulatory depression were observed. After cessation of MDZ, recovery from sedation was fast. The degree of amnesia was low. During constant rate infusion no increase in plasma concentration of either MDZ or metabolites occurred. T1/2 beta of MDZ after cessation was 125 min (range 90-320) and its total body clearance was 10.5 ml/kg/min (s.d. = 3.1). The volume of distribution, clearance and T1/2 beta were significantly longer in women than in men. It was concluded that 24 h of MDZ infusion at 5 mg/h caused satisfactory ICU sedation with fast recovery, but that individual tailoring of the infusion rate may still improve the quality of sedation.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Driessen JJ,Dirksen MS,Rutten JM,Santman F,van Egmond J,Vree TBdoi
10.1111/j.1399-6576.1989.tb02872.xsubject
Has Abstractpub_date
1989-02-01 00:00:00pages
116-21issue
2eissn
0001-5172issn
1399-6576journal_volume
33pub_type
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:1994-05-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:1983-04-01 00:00:00
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更新日期:2002-04-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:2018-11-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
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更新日期:1987-02-01 00:00:00
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更新日期:2016-09-01 00:00:00
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更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:The question whether some opioids exert less respiratory depression than others has not been answered conclusively. We applied pharmacokinetic/pharmacodynamic (PKPD) modeling to obtain an estimate of the C50 for the depression of CO2 elimination as a measure of the respiratory depressant potency of alfentani...
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pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
abstract::Female geriatric patients (mean age 80.9 years; n = 169) undergoing surgery for hip fracture were given epidural, neurolept analgesia, ketamine, enflurane or halothane anesthesia. The rate of survival in the different groups was studied up to 4 years after the operation and compared with the expected survival of norma...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1982.tb01825.x
更新日期:1982-12-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
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更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Hypophosphatemia has been associated with prolonged duration of respiratory failure and increased mortality in critically ill patients, but there is very limited evidence supporting the negative effects of low phosphate. We examined the association between hypophosphatemia at ICU admission and time to succes...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
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更新日期:2018-04-23 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00