Midazolam and flumazenil in neuroanaesthesia

Acta Anaesthesiologica Scandinavica. Supplementum
J Schulte am Esch, E Kochs

Abstract

Of the numerous benzodiazepines currently available, only a few are used in anaesthetic practice. Midazolam is utilised as a premedicant, sedative, and an induction agent and produces minimal depression of ventilation or of the cardiovascular system. The anticonvulsant activity is similar to that of diazepam. In neuroanaesthesia midazolam may be an acceptable alternative to other intravenous induction agents like barbiturates or etomidate in patients with compromised intracranial compliance. Midazolam produces dose-related reductions in cerebral blood flow and cerebral oxygen consumption. However, midazolam does not necessarily prevent increases in intracranial pressure during induction of anaesthesia. In the electroencephalogram (EEG) midazolam produces a reduction in alpha-activity, an increase in theta-delta-activity and low-voltage beta-activity. Midazolam like other benzodiazepines does not affect early components of auditory and somatosensory evoked responses, whereas late cortical responses may be suppressed. Flumazenil, a specific benzodiazepine antagonist, has been demonstrated to be effective in reversing benzodiazepine-induced sedation. In the EEG midazolam-induced changes vanish almost instantaneously. Flumazenil is...Continue Reading

References

May 1, 1986·Acta Anaesthesiologica Scandinavica·O K RoaldJ D Michenfelder
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Citations

Mar 20, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·B BissonnetteV Un
Jul 29, 1998·Electroencephalography and Clinical Neurophysiology·J M Guérit
Dec 22, 1999·British Journal of Clinical Pharmacology·M A HotzW E Haefeli
Jan 1, 1995·Acta Anaesthesiologica Scandinavica. Supplementum·R F McCloy
Sep 1, 1996·Electroencephalography and Clinical Neurophysiology·R ZaslanskyD Yarnitsky
Nov 29, 2015·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Masaaki NishidaEishi Asano
Jul 17, 2007·Journal of the Neurological Sciences·Marek A Mirski, Mitzi K Hemstreet
Nov 1, 1993·Journal of Clinical Anesthesia·B K Philip
Oct 10, 2018·Frontiers in Human Neuroscience·Antonia FleischmannMatthias Kreuzer

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