The manifestations of midazolam overdose are sedation, somnolence, confusion, impaired coordination, diminished reflexes, and untoward effects on vital signs, coma and possible cardio respiratory arrest. Treatment of midazolam overdose is the same as that followed for overdosage with other benzodiazepines. Continuous monitoring of vital signs including ECG should be immediately instituted and general supportive measures […]
Interventional techniques of musculoskeletal chronic pain management include use of nerve blocks, root blocks, rhizotomies, cordotomy, etc. Musculoskeletal chronic pain management is required during the following : 1. Low back pain – Lumbosacral, spinal/vertebral syndromes – Radiculopathy – Prolapsed intervertebral disc – Lumbar canal stenosis 2. Neuropathies: Trigeminal neuralgias (Tic doloroux) 3. Phantom limb pain,
The primary mechanism of protection of barbiturates drugs in cerebral ischemia has been attributed to its ability to decrease the cerebral metabolic rate of oxygen consumption (CMRO2), thereby increasing the ratio of oxygen supply to oxygen demand. Barbiturates drugs have been the prototype for anesthetic protection against cerebral ischemia. The decrease in CMRO2 is accompanied by a parallel
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Ketamine analgesia produces intense analgesia at sub anesthetic doses and prompt induction of anesthesia when administered IV at higher doses. Ketamine analgesia has an analgesic action at many sites both centrally and peripherally. These actions are mediated via multiple receptor subtypes, including opioid, NMDA, kainate, and GABAA receptors. Ketamine also inhibits serotonin and dopamine reuptake.
Lorazepam drip or Ativan drip is a frequently used sedative in the intensive care unit (ICU). It is a benzodiazepine that can be administered enterally, as intermittent parenteral doses, or as a continuous infusion. The beneficial effects of lorazepam drip include anterograde amnesia and an opioid-sparing effect via a moderation of the anticipatory pain response.
Broadly chronic pain syndrome type can be classified on the basis of aetiopathological origin of the syndrome of chronic pain. The advantage of using this classification is that while deciding the modality of control and management it becomes simpler to choose specific plan of management. 1. Non-oncogenic chronic pain: Chronic pain commonly seen in skeletal
In patients with acute renal failure, total body clearance is lower and the elimination half-life, while considering midazolam duration of action becomes longer than in patients with normal kidney function. In patients with impaired kidney function, the excretion of 1-hydroxymethyl midazolam glucuronide, the major metabolite of midazolam, is impaired. In healthy children aged 1 year
The ideal neuromuscular blocker drugs (NMB) would be rapid in onset, have a predictable offset, be nontoxic, lack deleterious cardiovascular or autonomic effects, undergo a defined means of metabolism and excretion preferably independent of end-organ function, and be inexpensive. Many of these characteristics are found in clinically available drugs like cisatracurium. To briefly review, neuromuscular
Propofol is known to possess direct antiemetic effects. Propofol antiemetic use for induction and maintenance of anesthesia has been shown to be associated with a lower incidence of postoperative nausea and vomiting (PONV) when compared to any other anesthetic drug or technique. It has been shown that total intravenous anaesthesia (TIVA) with propofol for anesthesia
Neo-Synephrine is the trade name for phenylephrine. It is a pure alpha receptor agonist and has both venous and arterial constrictive effects. Because Alpha1 receptors have been discovered in the myocardium, it is also possible that it has positive inotropic effects. In our current culture of patient safety, it is important to avoid commonly used medical
