Effects of a Midazolam-Ketamine Admixture in Human Volunteers

The ideal sedative is one that safely provides relief from pain, anxiety, and unpleasant memories for a wide variety of procedures. In reality there are few such agents; hence the need for a combination of agents. The subhypnotic administration of IV anesthetics during local or regional anesthesia is becoming more common. The technique of combining midazolam with ketamine has been termed dissociative sedation and may be considered as an alternative to other more traditional forms of conscious sedation or general anesthesia. Ketamine is a potent analgesic, and its analgesic effects continue after the sedative effects have worn off.

When used as the sole agent, ketamine at higher analgesic doses (>0.5 mgAg) is stimulating and is shown to resemble the dysphoric symptoms of psychosis as in schizophrenia. The coadministration of midazolam, however, has been clearly shown to attenuate the perceptual abnormalities and thought disorder induced by ketamine and does not affect amnesia or positive changes in mood that come with ketamine use.
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The incidence of cardiorespiratory events during midazolam-ketamine sedation is lower than that reported with other commonly used regimes. Combinations of ketamine and midazolam have been stated to be among the best and safest techniques for sedoanalgesia.

Midazolam and ketamine can both be administered many versatile ways via the oral, nasal, rectal, intramuscular, and intravenous routes. They do not induce pain on injection or phlebitis. This combination seems particularly beneficial because the elimination half-life of each agent is approximately the same. flomax drug

This study was conducted to determine if there was a difference in cardiorespiratory dynamics and plasma catecholamines after the intravenous administration of a midazolam-ketamine admixture to adult volunteers.