title: The combined effects of midazolam and propofol sedation on muscle power.
abstract: We performed a randomised, crossover study to investigate the effects of intravenous sedation on grip strength and bite force. Twenty male volunteers received a bolus intravenous injection of midazolam (0.02 mg.kg(-1)) together with a 30-min propofol infusion designed to achieve an effect-site concentration of 1.0 μg.ml(-1). Observed variables included bispectral index, observer's assessment of alertness/sedation, correct answer rate of Stroop colour-word test, grip strength and bite force. Grip strength decreased from a median (IQR [range]) of 483 (443-517 [380-586]) N to 358 (280-405 [108-580]) N (p < 0.001) during sedation and recovered following flumazenil administration, while bite force increased from 818 (593-1026 [405-1406]) N to 1377 (1243-1585 [836-2357]) N (p < 0.001) during sedation. Although bite force gradually returned to baseline following flumazenil administration, it remained increased throughout the experimental period. We conclude that bite force increased during intravenous sedation and that this may have clinical implications.
authors.affiliation: Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tomita
authors.forename: N
authors.initials: N
authors.lastname: Matsuura
authors.forename: T
authors.initials: T
authors.lastname: Ichinohe
mesh_terms: D000328:Adult; D001732:Bite Force; D016292:Procedural Sedation; D056805:Consciousness Monitors; D018592:Cross-Over Studies; D005442:Flumazenil / Q000494:pharmacology; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000494:pharmacology*; D053580:Muscle Strength / Q000187:drug effects*; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000187:drug effects*; D009483:Neuropsychological Tests; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D018401:Sample Size; D057190:Stroop Test
chemical_list: D006993:Hypnotics and Sedatives; D005442:Flumazenil; D008874:Midazolam; D015742:Propofol