title: Effects of midazolam on respiratory muscles in humans.
abstract: Midazolam at sedative doses alters the breathing pattern; however, its effects on respiratory load and respiratory muscle activity have not been established completely. Therefore, the effects of midazolam (0.1 mg/kg) on total pulmonary resistances and on diaphragmatic, intercostal, and abdominal muscle patterns were studied in nine volunteers. Measurements were performed during control, 5 and 10 min after midazolam, and then 2 min after 1.0 mg of intravenous flumazenil. After midazolam, total pulmonary resistance increased from 6.3 +/- 0.65 to 36.6 +/- 8.1 cm H2O-L-1 x s-1 (P < 0.01), a pattern associated with an increased intercostal electromyographic activity (peak and slope; P < 0.05). By contrast, the ratio of gastric pressure on esophageal pressure changes decreased from 65.5% +/- 6.2% to 16.3% +/- 3.9% (P < 0.01), indicating reduced diaphragmatic activity. In 7/9 subjects, there was expiratory abdominal muscle activity. Flumazenil reversed all these effects. We conclude that midazolam 0.1 mg/kg increases total pulmonary resistance and elicits a compensatory load response characterized by an increase in inspiratory intercostal and expiratory abdominal muscle activities whereas diaphragmatic contribution is reduced.
authors.affiliation: Départment d'Anesthésie et de Réanimation Chirurgicale, Hopital Bichat, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Molliex
authors.forename: B
authors.initials: B
authors.lastname: Dureuil
authors.forename: P
authors.initials: P
authors.lastname: Montravers
authors.forename: J M
authors.initials: JM
authors.lastname: Desmonts
mesh_terms: D000009:Abdominal Muscles / Q000187:drug effects*; D000328:Adult; D000403:Airway Resistance / Q000187:drug effects; D003964:Diaphragm / Q000187:drug effects*; D004576:Electromyography; D006801:Humans; D007366:Intercostal Muscles / Q000187:drug effects*; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D012132:Respiratory Muscles / Q000187:drug effects*
chemical_list: D008874:Midazolam