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Korean Journal of Anesthesiology 2008;55(6):680-684.
DOI: https://doi.org/10.4097/kjae.2008.55.6.680   
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
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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