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[The changes of bispectral index induced by administration of midazolam during propofol anesthesia]

Maiko Satomoto1, Hiroshi Aoki, Shigeyuki Yamada

  • 1Medical Corps, 1st Air Wing, Japan Air Self Defense Force, Hamamatsu 432-8551.

Masui. the Japanese Journal of Anesthesiology
|August 9, 2002
PubMed

Insights

Midazolam at 30 micrograms/kg significantly lowered the Bispectral Index (BIS) during propofol anesthesia. This suggests a potential interaction between midazolam and propofol affecting hypnotic depth monitoring.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Neuroscience

Context:

  • Propofol is a common anesthetic agent used for maintaining hypnosis during surgery.
  • Monitoring hypnotic depth, often using the Bispectral Index (BIS), is crucial for patient safety.
  • Understanding drug interactions is vital for optimizing anesthetic management.

Purpose:

  • To investigate the impact of additional midazolam or flumazenil on the Bispectral Index (BIS) during propofol-induced anesthesia.
  • To assess the synergistic effects between midazolam and propofol on hypnotic depth as measured by BIS.

Summary:

  • Twenty-two surgical patients receiving steady-state propofol anesthesia were administered midazolam (10 or 30 µg/kg) or flumazenil (6 or 12 µg/kg).
  • Only the higher dose of midazolam (30 µg/kg) significantly reduced the BIS values (from 47.8 ± 8.6 to 36.8 ± 6.5).
  • Flumazenil did not significantly alter BIS values.

Impact:

  • The findings suggest that while midazolam can enhance propofol's hypnotic effect as indicated by BIS, this interaction may be less pronounced than previously suggested by psychopharmacological studies.
  • This research contributes to a better understanding of drug interactions in anesthesia and their impact on electrophysiological monitoring.
  • Results may inform clinical practice regarding the combined use of midazolam and propofol for anesthesia depth management.

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