Midazolam, 0.2 mg/kg IV, for induction of intravenous versed anesthesia produces a greater decrease in systemic blood pressure and increase in heart rate than does diazepam, 0.5 mg/kg IV. The haemodynamic effects of midazolam are significant in humans. In normal humans, midazolam, 0.15 mg/kg IV over 15 seconds, produces statistically significant reduction in systolic (5%) […]
Propofol mechanism of action exerts its sedative hypnotic effects through a GABA receptor interaction. GABA is the principal inhibitory neurotransmitter in the CNS. When GABAA receptors are activated, transmembrane chloride conductance increases, resulting in hyperpolarization of the postsynaptic cell membrane and functional inhibition of the postsynaptic neuron. The interaction of propofol mechanism of action also
Midazolam pediatric dose loading dose may be followed by a continuous IV infusion to maintain the effect. IV loading doses should not be used in neonates. Continuous IV infusion for sedation in critical care settings is important in pediatric patients. To initiate sedation using midazolam, an IV loading dose of 0.05 to 0.2 mg/kg administered
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.
When administered intrathecal ketamine shows local anesthetic effects in both animals and humans. Intrathecal ketamine when used as a sole agent (0.7-0.95 mg/kg) with or without epinephrine for intrathecal use, although produces motor and sensory block but the analgesia is inadequate and of short duration along with varied psychomimetic disturbances. When added to the intrathecal
The sedative effect of benzodiazepines and opiods is potentiated by other CNS depressants including alcohol, barbiturates, inhaled and injected anesthetics, and opioids. Anesthetic requirements for inhaled and injected anesthetics are decreased by benzodiazepines and opiods . Benzodiazepines decrease the MAC value of inhaled anesthetics. Benzodiazepines, especially midazolam, potentiate the ventilatory depressant effects of opioids, though
Diazepam effects produce minimal depressant effects on ventilation with 0.2 mg/kg IV dose in Respiration system. The slight increase in PaCO2 is due primarily to a decrease in tidal volume. Nevertheless, nearly, small doses of diazepam (<10 mg IV) have produced apnoea. Combination of diazepam with other CNS depressants (opioids, alcohol) or administration of this
The effect of propofol on blood pressure is that it decreases systemic blood pressure. This decrease in propofol blood pressure is often accompanied by corresponding changes in cardiac output and systemic vascular resistance. Propofol decreases afterload more than thiopental and thus reduces systemic arterial pressure more than thiopental. Propofol preferentially decreases SVR without a significant
Benzodiazepines dependence may produce physical and psychological dependence after chronic (>6 months) use of commonly prescribed low-potency benzodiazepines. Withdrawal symptoms (irritability, insomnia, tremulousness) appear within 1 to 2 days for short-acting benzodiazepines dependence and within 2 to 5 days for longer-acting drugs. When administered to patients who have benzodiazepine induced CNS depression of benzodiazepines dependance, flumazenil produces rapid and dependable
Epidural ketamine and its active enantiomer S(+)ketamine have been used intrathecally and epidurally (caudally) for the management of perioperative pain and in a variety of chronic pain syndromes. Although ketamine has been reported to interact with opioid receptors, binding to local opiate receptors seems to play only a minor role, whereas significant analgesia after even
