The effect of remifentanil on sedation during midazolam induced sedation under brachial plexus block. |
Sung Jun Hong, Ji Soo Kim, Sung Mi Hwang, Jae Jun Lee, So Young Lim |
Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Chuncheon, Korea. h70sm@hallym.or.kr |
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Abstract |
BACKGROUND The effects of remifentanl on bispectral index (BIS) and sedation are controversial. The aim of this study was to evaluate the effects of continuous remifentanil infusion (0.03microgram/min/kg) on sedation by using BIS and the modified Observer's Assessment of the Alertness/Sedation Scale (OAA/S) during midazolam induced sedation after achieving pain free state by brachial plexus block. METHODS In this study 40 ASA physical status 1 or 2 adult patients scheduled to undergo upper extremity surgery under brachial plexus anaesthesia were included. After obtaining adequate brachial plexus block, patients were randomly allocated to two groups. All patents received a single dose of midazolam 2 mg intravenously and continuous infusion (2 mg/h). At 15 minutes after midazolam injection, Group C received saline infusion and Group R received additional remifentanil (0.4microgram/kg bolus plus continuous infusion (0.03microgram/kg/min)). The mean arterial blood pressure (MAP), heart rate (HR), SpO2, respiration rate (RR), and BIS were recorded every 5 min after injection of midazolam. The patient's level of sedation was assessed using the modified OAA/S and BIS immediately after MAP, HR, SpO2, and RR measurements. RESULTS There are no significant differences in MAP, HR, BIS, and the modified OAA/S between two groups but RR was significant reduced in Group R compared with Group C after remifentanil infusion. CONCLUSIONS The remifentanil showed no effect on BIS and the modified OAA/S during midazolam induced sedation under pain free state. |
Key Words:
bispectral index (BIS); midazolam; remifentanil; sedation |
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