Effects of a Midazolam-Ketamine Admixture in Human Volunteers: MATERIALS AND METHODS

In: Health

18 Sep 2009

Ten healthy individuals with a mean age of 29 years and a mean weight of 64 kg were enrolled. The study was approved by the institution’s human investigation committee, and written informed consent was obtained from all subjects. All subjects were ASA physical status I without psychiatric and psychological conditions and were not using any medications.

The subjects fasted overnight and were seen in the morning. After being placed in the supine position, routine clinical monitoring that included noninvasive arterial blood pressure, arterial oxygen saturation, tracheal auscultation, and a 3-lead ECG were applied throughout the entire study period. Following left forearm venipuncture with a 20- or 22-gauge cannula, an intravenous infusion of 0.9% saline was established. buy finasteride online

Midazolam was administered over 2 minutes at a loading dose of 0.07 mgAg and was followed by a ketamine bolus of 0.7 mgAg also over 2 minutes. Midazolam 0.07 mgAg was admixed with ketamine 0.7 mg/ kg, and saline was added to make a solution of 60 mL. This infusion was delivered over 1 hour via a 60 gtts/ mL IV infusion set at a constant rate of 60 gtts/min. Supplemental oxygen was delivered via a nasal mask.

Midazolam was administered first to allow for anxi-olysis and sedation and was subsequently followed by the ketamine. A ratio of 1:10 of midazolam to ketamine to achieve sedoanalgesia was chosen because of its easy clinical handling, because it is approximately half the dose used for the induction of general anesthesia, and because it was recommended by others.
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The participants were not unnecessarily stimulated and were allowed to sleep.

Measurements and blood samples were taken prior to the administration of the agents, immediately after the end of the loading doses, and at 10-minute intervals until 30 minutes after the discontinuation of the infusion.

Venous blood samples to measure plasma catecholamine levels were taken from the contralateral antecu-bital fossa.

Catecholamines

Plasma catecholamine levels were detected using an automated catecholamine analyzer (high pressure liquid chromatography [HPLC]) HLC-725 CA (Tosoh, Tokyo, Japan). Two milligrams of EDTA • 2 Na were added to 2 mL blood and centrifuged for 10 minutes; 0.6 mL of serum was removed, and to that was added 4.8% (0.3 mL) perchloric acid, and this was further centrifuged for 10 minutes. Next, 0.6 mL of plasma was removed to determine catecholamine levels. generic cymbalta

Statistical Analysis

Data were analyzed using an analysis of variance (AN-OVA) followed by a Bonferroni post hoc t-test, with P < 0.05 considered significant.

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