Document Detail


The effects of midazolam on the EEG during sedation of critically ill patients.
MedLine Citation:
PMID:  8322985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients who require mechanical ventilation are often sedated with midazolam. As clinical signs of sedation are often confusing or nonexistent, and there are few adverse side effects when large doses are infused over a period of days, substantial drug accumulation can result in these critically ill patients, despite the short half-life of midazolam. An objective monitor of sedation would help maintain sedation at a constant level despite changing pharmacokinetic values in patients. We undertook this study to describe the electroencephalographic changes which occur with intravenous midazolam in critically ill patients, and to determine if a relationship exists between these changes and the depth of sedation as measured using a clinical scoring method. A series of 31 critically ill patients who required intravenous midazolam during mechanical ventilation were studied. Four different levels of sedation were defined ranging from execution of verbal commands to no response to suctioning through the tracheal tube or sternal rub. Electroencephalographic recordings were obtained in patients on a daily basis and a concurrent sedation level was determined. High frequency electroencephalogram activity decreased as sedation level increased. This was reflected in decreases in the spectral edge (17.61 to 10.56 Hz (p = 0.0024)), the median frequency (4.27 to 2.56 Hz (p = 0.0278)), and the logarithm of the absolute power in the beta 1 (p = 0.0012), and beta 2 (p < 0.0001) bands. An incidental finding of asymmetry in power between right and left frontal electrodes was observed, with right-sided power being 9-18% greater (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R A Veselis; R Reinsel; P Marino; S Sommer; G C Carlon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  48     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-08-03     Completed Date:  1993-08-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  463-70     Citation Subset:  AIM; IM    
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York, N.Y. 10021.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain / drug effects
Critical Care
Critical Illness*
Electroencephalography / drug effects*
Female
Humans
Hypnotics and Sedatives
Male
Midazolam / pharmacology*
Middle Aged
Respiration, Artificial
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 59467-70-8/Midazolam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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