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Kurz, A; Sessler, DI; Annadata, R; Dechert, M; Christensen, R; Bjorksten, AR.
Midazolam minimally impairs thermoregulatory control.
Anesth Analg. 1995; 81(2):393-8 Doi: 10.1097/00000539-199508000-00032
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Kurz Andrea
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Abstract:
Perioperative hypothermia usually results largely from pharmacologic inhibition of normal thermoregulatory control. Midazolam is a commonly used sedative and anesthetic adjuvant whose thermoregulatory effects are unknown. We therefore tested the hypothesis that midazolam administration impairs thermoregulatory control. Eight volunteers were studied on 2 days each, once without drug and once at a target total plasma midazolam concentration of 0.3 micrograms/mL (corresponding to administration of approximately 40 mg over approximately 4 h). Each day, skin and core temperatures were increased sufficiently to provoke sweating, and then reduced to elicit peripheral vasoconstriction and shivering. We mathematically compensated for changes in skin temperature using the established linear cutaneous contributions to control of each response. From these calculated thresholds (core temperatures triggering responses at a designated skin temperature of 34 degrees C), we determined the thermoregulatory effects of midazolam. The sweating threshold was decreased approximately 0.3 degrees C by midazolam administration: 37.3 +/- 0.2 degrees C vs 37.0 +/- 0.3 degrees C (P = 0.0004, paired t-test). Midazolam decreased the core temperature that triggered vasoconstriction somewhat more: 37.1 +/- 0.2 degrees C vs 36.3 +/- 0.5 degrees C (P = 0.0002). Similarly, midazolam decreased the shivering threshold: 35.9 +/- 0.3 degrees C vs 35.3 +/- 0.6 degrees C (P = 0.03). The sweating-to-vasoconstriction (interthreshold) range, therefore, increased from 0.2 +/- 0.1 degrees C to 0.7 +/- 0.3 degrees C (P = 0.002). Although statistically significant, this relatively small increase contrasts markedly with the 3-5 degrees C interthreshold ranges produced by clinical doses of volatile anesthetics, propofol, and opioids.(ABSTRACT TRUNCATED AT 250 WORDS)
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Anesthetics, Inhalation - pharmacology
Blood Pressure - drug effects
Body Temperature - drug effects
Body Temperature Regulation - drug effects
Carbon Dioxide - metabolism
Electromyography - administration & dosage
Female - administration & dosage
Fingers - blood supply
Heart Rate - drug effects
Humans - administration & dosage
Midazolam - blood, pharmacology
Narcotics - pharmacology
Plethysmography - administration & dosage
Propofol - pharmacology
Regional Blood Flow - drug effects
Sensory Thresholds - drug effects
Shivering - administration & dosage
Skin Temperature - drug effects
Sweating - administration & dosage
Vasoconstriction - administration & dosage

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