Effect of Diazepam Preadministration on the Induction of Anesthesia with Thalamonal-N2O-Oxygen / 대한마취과학회지

ABSTRACT

Fentanyl is known to be non-toxic to liver and kidneys and provides stability to the cardiovascular system. So it is often recommended for anesthetising gerlatric or high risk patients as a relatively safe agent. But untoward reactions such as muscle rigiditiy, bradycardia, and hypotension may be troblesome. We administered diasepam(0.15~0.2 mg/kg) intravenously 10 minutes before injectiong thalamonal(0.1 mg/kg) to reduce muscle rigidity due to fentanly and observed the time required for loss of consciousness, muscle rigidity, respiratory depression, changes in cardiac rhythm, heart rate and blood pressure. The data was compared with those obtained from the patients in whom anesthesia was induced with thalarnonal without diazepam. The results were as follows 1) The patients preadministered with diazepam(experimental group) lost conscious on an average of 5 minutes and 43 seconds while the non-preadministered patients (control group) responded to verbal command even 15 minutes after thalmonal injection. 2) Muscle rigidity was observedn in 12 patients in the experimental group: 7 patients showed respiratory depression combined with muscle rigidity. There were no patients who developed muscle rigidity in the control group, although 7 patients had respiratory depression. 3) Arrhythmia was not obaserved in either group. 4) On intubation, blood pressure lowered significantly in the experimental group: 7 patients had hypotension in this group while only 1 patient had hypotension in the control group. 5) In the control group, there were 5 cases of bradycardia and 1 case of hypotensions, but they did not require any treatment. In the experimental group, 5 out of 8 developed bradycardia with hypotension and one case needed vasopressor treatment.