The effect of midazolam sedation on indicators for myocardial ischemia.
OBJECTIVE
The purpose of this investigation was to examine hemodynamic and electrocardiographic responses to local anesthesia.


METHODS
Seventy-five patients with heart disease were treated in 2 groups with lignocaine 2%, adrenaline 1:50,000, and vasopressin 0.25 IU, either alone or with midazolam. Heart rate, blood pressure, and electrocardiogram values were recorded, and the rate-pressure product and pressure-rate quotient were calculated as indicators for myocardial ischemia.


RESULTS
Sedation and anesthesia induced significant changes to the means for heart rate and systolic and mean blood pressure. For the anesthetic group, the maximum value for the rate-pressure product was 12,168 (95% CI = 1368), the minimum value for the pressure-rate quotient was 1.39 (95% CI = 0.04), and one patient exhibited minor changes to the S-T segment. For the sedated group, the rate-pressure product maximum was 9,882 (95% CI = 1,226) and the pressure-rate quotient fell to 1.13 (95% CI = 0.06), but no patient experienced ischemia.


CONCLUSIONS
Values for these indicators suggested that treatment did not generate significant ischemic risk.
Middlehurst
R
R
University Dental Hospital of Manchester, Unit of Oral and Maxillofacial Surgery, United Kingdom.
Coulthard
P
P
D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D016292:Procedural Sedation; D017742:Dental Care for Chronically Ill; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology*; D011446:Prospective Studies; D012189:Retrospective Studies
D018686:Anesthetics, Intravenous; D008874:Midazolam