[Is the plasma protein binding of lidocaine modified by the simultaneous administration of midazolam?].
Perioperative antiarrhythmic therapy with lidocaine (bolus dosage 100 mg followed by infusion of 200 mg/h) was performed in 24 patients; 12 of them simultaneously received an intravenous injection of 10 mg midazolam with the bolus of lidocaine (group I: with midazolam; group II: without midazolam). Central venous blood samples were collected over a period of 1 h (1, 3, 5, 10, 20, 30, and 60 min after the bolus) to evaluate unbound and total (protein-bound + unbound) plasma concentrations of lidocaine, thus calculating plasma protein binding. One minute after intravenous administration of lidocaine peak plasma concentrations occurred: in group I 5.38 +/- 1.99 micrograms/ml (mean +/- SD), in group II 5.25 +/- 1.90. Up to 60 min there was only a gradual decrease in plasma concentrations in both groups. There was no significant difference between the two groups (group I: mean free concentration 0.67-0.80 micrograms/ml; mean total concentration 4.84-5.38 micrograms/ml; mean plasma protein binding 83%-86%; group II: 0.69-0.89 micrograms/ml; 4.62-5.25 micrograms/ml; 82%-85%). We draw the conclusion that midazolam administration is safe in patients undergoing antiarrhythmic therapy or regional anesthesia with lidocaine.
Abteilung für Anaesthesiologie und Operative Intensivmedizin am Klinikum der Justus-Liebig-Universität Giessen.
R
R
Schürg
J
J
Biscoping
B
B
Bachmann-M
G
G
Hempelmann
D000328:Adult; D000765:Anesthesia, Conduction; D000769:Anesthesia, Inhalation; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000188:drug therapy; D001798:Blood Proteins / Q000378:metabolism*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000378:metabolism / Q000627:therapeutic use; D008874:Midazolam / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D010038:Otorhinolaryngologic Diseases / Q000601:surgery; D011485:Protein Binding / Q000187:drug effects
D001798:Blood Proteins; D008012:Lidocaine; D008874:Midazolam
Beeinflussung der Plasmaproteinbindung von Lidocain durch gleichzeitige Midazolam-Applikation?