title: The effects of midazolam and ketamine on D-tubocurarine-induced twitch depression in septic rat diaphragm.
abstract: The aim of this study was to elucidate the effects of midazolam and ketamine on neuromuscular blockade induced by non-depolarizing muscle relaxants (NDMRs) under the condition of sepsis induced by panperitonitis. A CLP operation (laparotomy, cecal ligation, and puncture of the cecum; septic group) or sham laparotomy (sham group) was performed on rats under O2-isoflurane anesthesia. At 18 hours after the operation, isometric twitch tensions of rat nerve-hemidiaphragm preparations elicited by indirect or direct stimulation at 0.1 Hz were measured. Midazolam enhanced the dTc (1 microM)-induced twitch depression (p < 0.05) at a high concentration (10 microM) in the septic group but not in the sham group. Ketamine enhanced the dTc (1 microM)-induced twitch depression in the sham group (p < 0.01) but not in the septic group. Midazolam and ketamine had no effect on directly elicited twitch tensions in either group. The results indicate that sepsis facilitates the midazolam-induced enhancement of the neuromuscular blocking effect of dTc but, conversely, inhibits the ketamine-induced enhancement. Sepsis elicits manifold alterations in the influence of intravenous anesthetics and sedatives on NDMR-induced neuromuscular blockade.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Hokkaido, Japan. enarimat@sapmed.ac.jp
authors.forename: E
authors.initials: E
authors.lastname: Narimatsu
authors.forename: M
authors.initials: M
authors.lastname: Aimono
authors.forename: Y
authors.initials: Y
authors.lastname: Nakayama
authors.forename: N
authors.initials: N
authors.lastname: Fujimura
authors.forename: M
authors.initials: M
authors.lastname: Kawamata
authors.forename: S
authors.initials: S
authors.lastname: Sumita
authors.forename: A
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000778:Anesthetics, Dissociative / Q000494:pharmacology*; D000818:Animals; D014151:Anti-Anxiety Agents / Q000494:pharmacology*; D003964:Diaphragm / Q000187:drug effects / Q000503:physiopathology*; D004347:Drug Interactions; D004558:Electric Stimulation; D007649:Ketamine / Q000494:pharmacology*; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D009119:Muscle Contraction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D010538:Peritonitis / Q000503:physiopathology; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000503:physiopathology*; D014403:Tubocurarine / Q000494:pharmacology*
chemical_list: D000778:Anesthetics, Dissociative; D014151:Anti-Anxiety Agents; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D008874:Midazolam; D014403:Tubocurarine