Cardiovascular Effects of Sedative Infusions of Propofol and Midazolam after Spinal Anaesthesia
Key result
Propofol and midazolam infusions after spinal anaesthesia caused similar additional reductions in systolic (10 mmHg) and diastolic (4 mmHg) blood pressure and decreased heart rate (P<0.005).
Why the study?
Do sedative infusions of propofol or midazolam alter cardiovascular parameters in patients after spinal anaesthesia compared to saline?
Population
50 patients after spinal anaesthesia for lower limb or pelvic surgery
Comparison
Intravenous sedation with propofol (mean dosage… vs Saline infusion only (n=10)
Design
Other
Follow-up
40 minutes in theatre plus recovery period
Authors
Discussion
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Implication
Clinicians should monitor for mild BP and HR reductions with either agent after spinal anesthesia; hypothesis-generating and should not yet change practice.
Study Design
Type
RCT (n=50)
Structured PICO
Do sedative infusions of propofol or midazolam alter cardiovascular parameters in patients after spinal anaesthesia compared to saline?
P
Population
50 patients receiving intravenous sedation after spinal anaesthesia for lower limb or pelvic surgery, monitored for 40 minutes.
I
Intervention
Intravenous sedation with propofol (mean dosage 74 (SD 4) micrograms/kg/min for 0-20 minutes and 51 (SD 7) micrograms/kg/min for 20-40 minutes, n=20) or midazolam (35 micrograms/kg + 2.54 (SD 0.2) micrograms/kg/min for 0-20 minutes and 1.35 (SD 0.2) micrograms/kg/min for 20-40 minutes, n=20)
C
Comparator
Saline infusion only (n=10)
O
Outcome
Cardiovascular effects including systolic and diastolic blood pressure, heart rate, and forearm vasoconstriction (measured by strain gauge plethysmography)surrogate
Main Result
p-value: p=<0.005
Both propofol and midazolam cause similar mild reductions in blood pressure and heart rate when used for sedation after spinal anaesthesia, but propofol offers a significantly faster recovery.
Cite This Study
Blake et al. (1988) conducted an RCT in Spinal anaesthesia for lower limb or pelvic surgery (n=50). Propofol and Midazolam vs. Saline infusion was evaluated on Cardiovascular effects (blood pressure, heart rate, forearm vasoconstriction) (p=<0.005). Propofol and midazolam infusions after spinal anaesthesia caused similar additional reductions in systolic (10 mmHg) and diastolic (4 mmHg) blood pressure and decreased heart rate (P<0.005).