Abstract
Purpose
This study examined in an animal model whether intrathecal midazolam, alone or with fentanyl, can achieve anaesthesia sufficient for laparotomy, comparable to lidocame. Effects on consciousness and whether anaesthesia was segmental were also examined. The haemodynamic and respiratory changes were compared with those of intrathecal lidocame or intrathecal fentanyl alone.
Methods
Sixty Wistar strain rats, with nylon catheters chronically implanted in the lumbar subarachnoid theca, were divided into six groups. Group 1 (n = 12) received 75 μL intrathecal lidocame 2%. Group 2 (n = 12) received 75 μL intrathecal midazolam 0.1 %. Group 3 (n = 12) received intrathecal 37.5 μL midazolam 0.1 %, plus 37.5 μL fentanyl 0.005%. Group 4 (n = 12) received intrathecal 50 μL fentanyl 0.005%. Group 5 (n = 6) received 75 μL midazolam 0.1 %iv. Group 6 (n = 6) received halothane 0.6% in oxygen by inhalation.
Results
Both groups that received intrathecal midazolam, alone or combined with fentanyl, developed effective segmental sensory and motor blockade of the hind limbs and abdominal wall, sufficient for a pain-free laparotomy procedure. Neither of these groups, unlike the group that received intrathecal lidocame, developed a reduction in blood pressure or change in heart rate at the time of maximal sensory or motor blockade, nor were there changes in the arterial blood gases or respiratory rate.
Conclusion
Midazolam. when injected intrathecally. produces reversible, segmental, spinally mediated antinociception, sufficient to provide balanced anaesthesia for abdominal surgery.
Résumé
Objectif
Un modèle animal a servi à examiner si le midazolam sous-arachnoïdien seul ou avec du fentanyl pouvait produire une anesthésie comparable à celle de la lidocaïne et suffisante pour une laparotomie. Les effets sur la conscience ainsi que les caractéristiques segmentaires de l’anesthésie ont aussi été étudiés. Les changements hémodynamiques et respiratoires ont été comparés à ceux de la lidocaïne et du fentanyl sous-arachnoïdiens seuls.
Méthodes
Soixante rats de souche Wistar porteurs de cathéters sous-arachnoïdiens implantés ont été répartis entre six groupes. Le groupe I (n= 12) recevait 75 μL de lidocaïne sous-arachnoïdienne, le groupe 2 (n= 12) recevait 75 μL de midazolam sous-arachnoïdien. le groupe 3 (n= 12) recevait 37,5 μL de midazolam et 37,5 μL de fentanyl 0.005% sous-arachnoïdiens, le groupe 4 (n= 12) recevait 50μL de fentany 10,005% sous-arachnoïdien, le groupe 5 (n = 6) recevait 75 μL de midazolam intraveineux, le groupe 6 recevait de l’halothane 0,6% en oxygène par inhalation.
Résultats
Les deux groupes qui avaient reçu du midazolam sous-arachnoïdien seul ou combiné au fentanyl ont eu une anesthésie efficace segmentaire sensitive et motrice du train posténeur et de la paroi abdominale suffisante pour une laparotomie. Aucun de ces groupes, contrairement au groupe qui avait reçu de la lidocaïne sous-arachnoïdienne, n’a présenté de chute de pression arténelle ou de changements de la fréquence cardiaque au moment du block sensitif et moteur maximum ni d’altérations de la gazométne arténelle et de la fréquence respiratoire.
Conclusion
Le midazolam sous-arachnoïdien produit une bloc nociceptif réversible, segmentaire, d’ongine rachidienne, suffisant pour procurer une anesthésie équilibrée et adéquate pour une chirurgie abdominale.
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Bahar, M., Cohen, M.L., Grinshpon, Y. et al. Spinal anaesthesia with midazolam in the rat. Can J Anaesth 44, 208–215 (1997). https://doi.org/10.1007/BF03013011
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DOI: https://doi.org/10.1007/BF03013011