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Electroencephalographic response following midazolam-induced general anesthesia: relationship to plasma and

Wakako Miyake1, Yutaka Oda, Yuko Ikeda

  • 1Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abeno-ku, Osaka 545-8586, Japan.

Journal of Anesthesia
|March 16, 2010
PubMed

Insights

This study found that while midazolam dose affects electroencephalographic parameters, its effect-site concentration did not correlate with Bispectral Index (BIS) or SEF95. Increased beta-band power was observed post-induction.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Pharmacology

Background:

  • Midazolam is a common anesthetic agent used for induction.
  • Understanding its relationship with electroencephalographic (EEG) parameters is crucial for safe anesthesia.
  • The effect-site concentration (Ce) is a key pharmacokinetic parameter influencing drug effect.

Purpose of the Study:

  • To investigate the correlation between midazolam's effect-site concentrations and EEG parameters during general anesthesia induction.
  • To evaluate the relationship between different midazolam doses and EEG responses.
  • To assess the predictive value of EEG parameters for midazolam's effect.

Main Methods:

  • A double-blind study involving 24 patients (ASA I or II) receiving either 0.2 mg/kg or 0.3 mg/kg of intravenous midazolam.
  • Continuous monitoring of Bispectral Index (BIS), 95% spectral edge frequency (SEF95), spectral power density, and plasma midazolam concentrations for 60 minutes post-induction.
  • Calculation of simulated effect-site concentrations (Ce) of midazolam.

Main Results:

  • Higher midazolam doses resulted in significantly higher plasma and simulated effect-site concentrations.
  • A positive correlation was found between the relative beta ratio and BIS (r² = 0.30).
  • Midazolam effect-site concentrations did not show significant association with BIS, relative beta ratio, or SEF95.
  • Electroencephalographic spectral power density in the beta-band significantly increased post-induction, particularly in the higher-dose group.

Conclusions:

  • The Bispectral Index (BIS) positively correlated with the relative beta ratio following midazolam induction.
  • Despite rapid decreases in midazolam concentrations, BIS remained elevated (>60) for 60 minutes, indicating sustained EEG changes.
  • Effect-site concentrations of midazolam did not directly correlate with BIS or SEF95, suggesting complex EEG modulation by the drug.
Abstract

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