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Abstract

In this study, by measuring bispectral index (BIS), we tested the hypothesis that intravenous adenosine 5′-triphosphate (ATP) infusion would deepen the level of midazolam-induced sedation. Ten healthy volunteers underwent 2 experiments with at least 2 weeks' interval: immediately after intravenous bolus administration of midazolam (0.04 mg/kg), they received continuous infusion of either ATP infusion (100 μg/kg/min) or placebo (saline) for 40 minutes in a double-blind, randomized, crossover manner. Changes in BIS values and responsiveness to verbal command as well as cardiorespiratory variables were observed throughout the study periods. Administration of midazolam alone reduced BIS value from control: 97 ± 1 to 68 ± 18 at 25 minutes, which was accompanied by significant cardiopulmonary depressant effects, while maintaining responsiveness to verbal command (consciousness) throughout the study period. Coadministration of ATP with midazolam further reduced BIS value to 51 ± 13, associated with complete loss of consciousness without adverse effect on the cardiorespiratory systems. We conclude that the addition of ATP infusion to midazolam significantly enhances midazolam sedation without disturbing cardiorespiratory functions.

Keywords: Midazolam sedation; ATP; Central adenosine receptors
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Copyright: © 2014 by the American Dental Society of Anesthesiology
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Article Contents

Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report

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 MinHye So MD, PhD;,
 Kazuma Fujikake MD, PhD;,
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 Yuji Kamimura MD, PhD;,
 Haruko Ota MD, PhD;,
 Tomomi Mizutani DDS,
 Kenichiro Ishibashi DDS, PhD;,
 Yasuyuki Shibuya DDS, PhD;, and
 Kazuya Sobue MD, PhD

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 Naotaka Kishimoto DDS, PhD

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 Mami Asai DDS,
 Yuko Shikama DDS,
 Hiroko Kobayashi DDS,
 Makoto Hirohata DDS,
 Naoko Tachi DDS, PhD, and
 Masahiro Okuda MD, PhD
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