Skip to main content

Electromyographic assessment of blink and corneal reflexes during midazolam administration: useful methods for assessing depth of anesthesia?

Buy Article:

$43.00 plus tax (Refund Policy)

Background:

There are at least three components of the anesthetic state: loss of consciousness, amnesia and obtundation of reflex responses to noxious stimuli. To investigate the third component, we used a standard electrical stimulus to evoke a blink reflex, which was electromyographically recorded. These data may give information on the anesthetic state. Methods:

The relation between the electrically evoked blink and corneal reflexes and the depth of sedation and anesthesia induced with intravenous midazolam was investigated. Ten patients received i.v. increments of midazolam (1 mg, 2 mg, 3 mg, 3 mg, 3 mg, etc., until a 21-mg total dose) to create a step-wise deepening of sedation and anesthesia. Depth of anesthesia was assessed by the Observer's Assessment of Alertness/Sedation (OAAS) scale, ranging from 5 ( =  awake and alert) to 0 ( =  no motor response to tetanic stimulation). Results:

Latency of the first (R1) and second (R2) blink components and the corneal (C) reflex component increased, whereas duration and area decreased with increasing depth of sedation and anesthesia. R1 was last seen at an OAAS score [mean (SD)] of 1.8 (0.8), R2 at a score of 3.1 ( 1.1), C at a score of 3.8 (0.8), and R3 at 4.8 (0.5). These end-points were all statistically different from each other, except R2 vs. C. Conclusions:

Our results suggest that the differential sensitivity of the components of the blink reflex could be useful to monitor depth of sedation and light levels of anesthesia during the administration of midazolam.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: Benzodiazepine; blink reflex; corneal reflex; human; hypnotic level; monitoring; sedation

Document Type: Research Article

Affiliations: 1: Anesthesiology and 2: Clinical Neurophysiology, University Medical Center Nijmegen, HB, Nijmegen, the Netherlands.

Publication date: 2003-05-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more