Comparison of the effect of electrical stimulations on the chin skin on autonomic nervous activities during propofol sedation with or without midazolam

Publication date: Available online 20 April 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Karin Sawaguchi, Nobuyuki Matsuura, Tatsuya Ichinohe
PurposeThe aim of this study was to compare the effect of electrical stimulations on the chin skin on autonomic nervous activities evaluated by using power spectrum analysis of heart rate variability during intravenous sedation using propofol with or without midazolam.Patients and MethodsThirty-eight healthy adult male volunteers underwent intravenous sedation with midazolam and propofol (Group MP) and with propofol (Group P) in a randomized crossover manner. In Group MP, the subjects received midazolam (0.04 mg/kg) and target-controlled infusion of propofol with predicted blood concentration of 1.0 μg/mL. In Group P, predicted blood concentration of propofol was maintained at 1.5 μg/mL. The observed variables were bispectral index (BIS) value, systolic blood pressure (SBP), heart rate (HR), high frequency component (HF), low frequency component (LF), and LF/HF ratio. Measurements were conducted over 100-second periods and carried out before, during, and after emergence from sedation by administering 0.2 mg flumazenil. Paired t-test, Wilcoxon's t-test, repeated-measures analysis of variance (ANOVA), and Friedman chi-square r-test were used for statistical analyses.ResultsThe mean age and body weight of the subjects was 24.6 ± 2.8 years and 67.0 ± 7.9 kg, respectively. BIS values, SBP and HR showed similar changes in both groups. LF/HF ratio in Group MP during sedation was lower than that at control, and was also lower than LF/HF ratio in Group P during sedation.ConclusionIntravenous sedation with a combination of midazolam and propofol inhibited sympathetic nervous activation induced by electrical stimulations to a greater extent than that with propofol alone.



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