Systemic lidocaine decreases the Bispectral Index in the presence of midazolam, but not its absence - 11/03/12

Doi : 10.1016/j.jclinane.2011.06.018

Antje Gottschalk, MD ^a,^b : Research Fellow, Allannah M. McKay, MD ^a : Research Fellow, Zahra M. Malik, MS ^a : Medical Student, Michael Forbes, MS ^a : Medical Student, Marcel E. Durieux, MD, PhD ^a : Professor of Anesthesiology and of Neurological Surgery, Danja S. Groves, MD, PhD ^a,^{^⁎} : Associate Professor of Anesthesiology
^a Department of Anesthesia, University of Virginia, Charlottesville, VA 22908-0710, USA
^b Department of Anesthesiology and Intensive Care Medicine, University of Muenster, Muenster 48149, Germany

^⁎Correspondence: Danja S. Groves, MD, PhD, Department of Anesthesia, University of Virginia, P.O. Box 800710, Charlottesville, VA 22908-0710, USA. Tel.: 001-434-924-2283; fax: 001-434-982-0019.

Abstract

Study Objective

To evaluate the effects of intravenous (IV) lidocaine on the Bispectral Index (BIS) in the presence or absence of midazolam.

Design

Prospective, randomized, double-blinded, placebo-controlled clinical study.

Setting

Operating room of a university hospital.

Patients

96 ASA physical status 1, 2, and 3 patients undergoing general anesthesia.

Interventions

Patients were assigned to one of 6 treatment groups to receive IV midazolam (0.03 mg/kg) or placebo, followed 5 minutes later by one of three IV preinduction doses of lidocaine: 0.5, 1.0, or 1.5 mg/kg.

Measurements

BIS values were recorded before administration of lidocaine and at 30-second intervals afterwards for three minutes. The primary endpoint was the average BIS level recorded.

Main Results

Baseline BIS values were lower in the midazolam group (94 ± 4 vs. 90 ± 7, P < 0.001). There was no significant decrease in BIS values in the placebo group for any of the three lidocaine doses. However, in the midazolam groups, significant decreases in BIS levels versus baseline values were measured.

Conclusion

IV lidocaine decreases BIS in the presence of midazolam, suggesting that the effect of lidocaine on BIS is not direct, but rather results from modulation by midazolam.

Le texte complet de cet article est disponible en PDF.

Keywords : Bispectral Index (BIS), Lidocaine, Midazolam

Plan

Introduction

Materials and methods

Effect of lidocaine on BIS

Effect of lidocaine on anesthesia

Lidocaine and GABA signaling

Summary

☆	Funding: The study was solely supported by departmental funding.
☆☆	Conflict of interest: The authors do not have any conflict of interest.
★	Reprints will not be available from the authors.

Export

Vol 24 - N° 2

P. 121-125 - mars 2012 Retour au numéro

Article précédent

Does the covering of children during induction of anesthesia have an effect on body temperature at the end of surgery?
Mohanad Shukry, Lacey Matthews, Alberto J. de Armendi, Bradley P. Kropp, Dominic Frimberger, Jorge A. Cure, James Mayhew

| Article suivant

Low social support is associated with an increased risk of postoperative delirium
Thuy-Dung Do, Cédric Lemogne, Didier Journois, Denis Safran, Silla M. Consoli

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Systemic lidocaine decreases the Bispectral Index in the presence of midazolam, but not its absence - 11/03/12

Abstract

Study Objective

Design

Setting

Patients

Interventions

Measurements

Main Results

Conclusion

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL