Plasma catecholamine concentration during sedation in ventilated patients requiring intensive therapy.
The effects of isoflurane and midazolam sedation on the catecholamine responses of ventilated patients were studied over a 24-h period. Sixty ventilated patients admitted to our intensive therapy unit were allocated randomly to receive either isoflurane or midazolam sedation. Arterial blood samples for plasma catecholamine concentrations were taken at baseline, 6 h after starting sedation and at the end of the study period. Patients sedated with isoflurane showed a progressive reduction in both adrenaline and noradrenaline concentrations during the period of sedation which reached statistical significance for adrenaline at 6 h (p less than 0.02) and at the end of the study (p less than 0.001). Patients sedated with midazolam showed no significant changes of adrenaline or noradrenaline concentrations. Overall, a more satisfactory degree of sedation was achieved with isoflurane.
Sir Humphrey Davy Department of Anaesthesia, Bristol Royal Infirmary, UK.
K L
KL
Kong
S M
SM
Willatts
C
C
Prys-Roberts
J T
JT
Harvey
S
S
Gorman
D000280:Administration, Inhalation; D000368:Aged; D003422:Critical Care; D004837:Epinephrine / Q000097:blood*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007530:Isoflurane / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D012890:Sleep / Q000187:drug effects*; D013312:Stress, Physiological / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology
D007530:Isoflurane; D008874:Midazolam; D009638:Norepinephrine; D004837:Epinephrine