COMPARATIVE STUDY OF MIDAZOLAM AND FENTANYL ON INDUCTION DOSE OF PROPOFOL IN PATIENTS SCHEDULED FOR ELECTIVE ABDOMINOPELVIC SURGERIES.

Document Type : Original Article

Authors

1 Department of Anaesthesia, National Orthopaedic Hospital Igbobi Lagos State, Nigeria.

2 Department of Anaesthesia, Faculty of Clinical Sciences , College of Health Sciences. University of Ilorin, Ilorin. Kwara State ,Nigeria

3 Department of Anaesthesia , Faculty of Clinical Sciences , College of Health Sciences University of Ilorin, Ilorin, Kwara State Nigeria

Abstract

BACKGROUND: Propofol is one of the most commonly used anaesthetics but is associated with dose-dependent side effects. Reducing the dose of propofol to avoid these unwanted effects may result in awareness under anaesthesia; while its generous administration to achieve a good depth may cause significant side effects. Pretreatment of patients with another agent like fentanyl, midazolam, prior to propofol induction has been shown to reduce the induction dose of propofol and promote haemodynamic stability.
OBJECTIVE: The aim of this study was to compare the induction dose of propofol following fentanyl or midazolam pretreatments.
METHODOLOGY: This randomized study enrolled eighty ASA I and II patients aged 18-65 into 2 groups (M and F) of forty patients each to be pretreated with 0.05mg/kg midazolam and 2ug/kg fentanyl prior to induction of anaesthesia with propofol. The outcome measures were induction dose of propofol, induction time, haemodynamic changes, sedation scores and side effects.
RESULTS: The induction dose of propofol was 79.8± 13.9mg and 67.2± 10.5mg, p-value=0.047 ; mean induction doses of propofol were 1.23± 0.27 mg/kg and 1.05± 0.22 mg/kg, p-value=0.04; and the mean induction time were 84.0 ± 18.7s and 73.3 ± 20.1s, p-value=0.148; median sedation scores were 2(1-3) and 3.5(3-5), p value= 0.01, respectively for groups F and M. The pre and post induction reductions of PR, DBP, and MAP from baseline values were comparable between the two groups.
CONCLUSION: Pretreatment with midazolam reduced the induction dose of propofol, increased induction time, sedation scores and incidence of hypotension compared to fentanyl.

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