HYPNOTIC AND ANESTHETIC INTERACTIONS BETWEEN MIDAZOLAM, PROPOFOL AND ALFENTANIL
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AbstractWe have examined interactions between midazolam, propofol and alfentanil using two end-points of light sedation (hypnosis) and anaesthesia. Quantal dose-response curves were determined in 400 female patients for the drugs individually and in combination. At the hypnotic end-point interactions were analysed by fitting the data to a mathematical model where the response depended on the doses of the three drugs with additional terms included to describe non-additive interactions of the various combinations of the three drugs. There were significant interactions for hypnosis; the decrease in expected ED50 for the various combinations were: midazolam-propofol = 37 %, midazolam-alfentanil = 46 %, propofol-alfentanil = 20 %, midazolam-propofol-alfentanil = 42 %. Whilst all responses to the two-drug combinations were synergistic, the three-drug combination led to a response that was less than that expected from the effects of the individual agents and their two drug interactions. For anaesthesia, dose-related effects could not be demonstrated for midazolam or alfentanil when used alone. The decrease in ED50 of propofol in the presence of the other compounds was propofol-midazolam = 52 %, propofolalfentanil = 73 %, propofol-midazolam-alfentanil = 82 %. When comparing the different combinations, the responses varied markedly at each end-point assessed and could not be predicted from the responses of the individual agents.
All Author(s) ListSHORT TG, PLUMMER JL, CHUI PT
Journal nameBritish Journal of Anaesthesia
Year1992
Month8
Day1
Volume Number69
Issue Number2
PublisherPROF SCI PUBL
Pages162 - 167
ISSN0007-0912
eISSN1471-6771
LanguagesEnglish-United Kingdom
KeywordsANALGESICS, ALFENTANIL; ANESTHETICS, INTRAVENOUS, PROPOFOL; HYPNOTICS, BENZODIAZEPINES, MIDAZOLAM; PHARMACOLOGY, DRUG INTERACTIONS
Web of Science Subject CategoriesAnesthesiology; ANESTHESIOLOGY

Last updated on 2020-30-05 at 01:00