British Journal of Anaesthesia, Vol 76, Issue 5 663-667, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
G. B. Drummond
Male patients, aged 27-74 yr, without hypertension or overt cardiovascular
disease were premedicated with temazepam 20 mg orally and allocated
randomly to receive sedation with either midazolam (12 patients) in a dose
sufficient to provide light sedation (retained response to loud voice) or
ketamine 1 mg kg-1 (11 patients). Median midazolam dose was 0.08
(interquartile range 0.02) mg kg-1. The activity of the muscles of the
tongue, anterior neck and scalene group was measured with surface
electrodes and compared with the awake state. Muscle activity decreased
significantly after midazolam in each group of muscles, to median values of
42%, 28% and 33%, respectively, of awake values. Airway obstruction
occurred in 10 of 12 patients and during obstruction muscle activity
increased significantly to 69%, 73% and 52% of awake values, but in all
cases this was insufficient to overcome the obstruction. After ketamine,
activity did not change significantly and there were no episodes of airway
obstruction. Phasic muscle activity was noted after sedation in 11 subjects
but there was no difference in the incidence between the two groups
(midazolam, six patients; ketamine, five patients).
CLINICAL INVESTIGATIONS
Comparison of sedation with midazolam and ketamine: effects on airway muscle activity
University Department of Anaesthetics, Royal Infirmary, Edinburgh EH3 9YW
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