title: A dose-response study of the effects of intravenous midazolam on cold pressor-induced pain.
abstract: The effects of intravenous midazolam (0.75, 1.5, and 3 mg/70 kg) were examined and compared to that of fentanyl (0.1 mg/70 kg; positive control) and saline on pain induced by a cold pressor test. Both sensory and affective components of the pain response were assessed, as there is some evidence that benzodiazepines reduce the affective component. Healthy volunteers (three females, nine males) were enrolled in a prospective, double-blind, randomized, cross-over trial in which mood and psychomotor performance were also examined. Five minutes and 135 min postinjection, subjects immersed their forearm in ice-cold water for 3 min while assessments of pain were recorded. During the first immersion, subjects reported significantly lower pain intensity and bothersomeness ratings after having been injected with fentanyl, relative to the saline and midazolam conditions, which did not differ significantly from each other. Fentanyl and midazolam had prototypical mood altering and psychomotor impairing effects. We conclude that midazolam in our laboratory setting at the doses and route of administration studied had no effects on either the sensory or affective components of the pain experience.
authors.affiliation: Department of Anesthesia and Critical Care, University of Chicago, Illinois 60637.
authors.forename: J P
authors.initials: JP
authors.lastname: Zacny
authors.forename: D
authors.initials: D
authors.lastname: Coalson
authors.forename: C
authors.initials: C
authors.lastname: Young
authors.forename: J
authors.initials: J
authors.lastname: Klafta
authors.forename: G
authors.initials: G
authors.lastname: Rupani
authors.forename: P
authors.initials: P
authors.lastname: Thapar
authors.forename: M
authors.initials: M
authors.lastname: Choi
authors.forename: J L
authors.initials: JL
authors.lastname: Apfelbaum
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D003080:Cold Temperature; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000494:pharmacology; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects*; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects
chemical_list: D008874:Midazolam; D005283:Fentanyl