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The effect of midazolam sedation on indicators for myocardial ischemia
1University Dental Hospital of Manchester, Unit of Oral and Maxillofacial Surgery, United Kingdom.
Objective:
The purpose of this investigation was to examine hemodynamic and electrocardiographic responses to local anesthesia.
Study Design:
Seventy-five patients with heart disease were treated in 2 groups with lignocaine 2%, adrenaline 1:50,000, and vasopressin 0.25 IU, either alone or with midazolam. Heart rate, blood pressure, and electrocardiogram values were recorded, and the rate-pressure product and pressure-rate quotient were calculated as indicators for myocardial ischemia.
Results:
Sedation and anesthesia induced significant changes to the means for heart rate and systolic and mean blood pressure. For the anesthetic group, the maximum value for the rate-pressure product was 12,168 (95% CI = 1368), the minimum value for the pressure-rate quotient was 1.39 (95% CI = 0.04), and one patient exhibited minor changes to the S-T segment. For the sedated group, the rate-pressure product maximum was 9,882 (95% CI = 1,226) and the pressure-rate quotient fell to 1.13 (95% CI = 0.06), but no patient experienced ischemia.
Conclusion:
Values for these indicators suggested that treatment did not generate significant ischemic risk.