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[Midazolam for rapid sequence induction].

T Nishiyama1, A Hirasaki, Y Odaka

  • 1Department of Anesthesiology, Kagawa Prefectural Central Hospital, Takamatsu.

Masui. the Japanese Journal of Anesthesiology
|February 1, 1990
PubMed
Summary
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Midazolam is a safe and effective agent for rapid sequence induction, offering stable hemodynamics and fewer arrhythmias compared to thiamylal. This anesthetic choice may reduce overall anesthetic requirements.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Rapid sequence induction (RSI) is a critical procedure in anesthesia.
  • Thiamylal has been a traditional agent for RSI, but carries risks.
  • Alternative agents are sought to improve patient safety and hemodynamic stability.

Purpose of the Study:

  • To compare the efficacy and safety of midazolam versus thiamylal for rapid sequence induction.
  • To evaluate hemodynamic changes and incidence of arrhythmias during RSI with midazolam and thiamylal.

Main Methods:

  • A comparative study involving two groups of patients undergoing RSI.
  • One group received midazolam (0.2 mg.kg-1) and fentanyl (50 micrograms).
  • The other group received thiamylal (4 mg.kg-1).

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Main Results:

  • No significant difference in induction-to-intubation time between midazolam and thiamylal groups.
  • Midazolam group exhibited smaller changes in systolic and diastolic blood pressure and heart rate post-intubation.
  • No arrhythmias were observed in the midazolam group at intubation; reduced anesthetic requirements were noted.

Conclusions:

  • Midazolam is a useful and safe agent for rapid sequence induction, particularly in patients with asthma or drug allergies.
  • Midazolam provides superior hemodynamic stability and a lower incidence of arrhythmias compared to thiamylal.
  • The use of midazolam may allow for a reduction in overall anesthetic dosage during the peri-intubation period.