Year: 2015 | Month: September | Volume 2 | Issue 3
Changes in Intra-cerebral Oxygenation During Intravenous and Inhalational Sedation: A Original Research
Kenichi Satoh
Mami Chikuda
Ayako Ohashi
Miho Kumagai
Masahito Sato
Shigeharu Joh
DOI:10.5958/2394-4196.2015.00018.7
Abstract:
Although sedatives such as midazolam or nitrous oxide (N2O) are administered to dental patients, the effects of these drugs on intra?-cerebral oxygenation are not well?-known. Aims: We investigated the effects of intravenous midazolam or inhalational N2O on intra?-cerebral oxygenation using near?-infrared spectroscopy. Setting and Design: University hospital, prospective. Materials and Methods: During intravenous sedation, volunteers received supplemental oxygen through nasal cannula at 3 L/min for 10 min (control group). Midazolam (0.05 mg/kg) was then injected intravenously with flumazenil (20 mg) injected 30 min later. In the inhalational sedation study, volunteers lay quietly for 10 min receiving 100% oxygen, then received N2O via nasal mask at concentrations of 10%, 20%, and 25% for 5 min; 30% for 20 min; and supplemental oxygen at 100% for 15 min after N2O was discontinued. Statistical Analysis: Intra?-group comparisons were made using one?-way analysis of variance for repeated measures followed by Dunnett’s test for multiple comparisons. Differences were considered statistically significant at P < 0.05. Results: During intravenous sedation, oxyhemoglobin increased 10 min after midazolam administration, and total hemoglobin increased slightly until 20 min after flumazenil administration, followed by a decrease. During inhalational sedation, oxyhemoglobin increased until 5 min after starting N2O, and total hemoglobin increased until 5 min after starting N2O, followed by a decrease. Conclusions: Midazolam and N2O influenced intra?-cerebral oxygenation during intravenous or inhalational sedation. Cerebral blood flow increased with intravenous sedation when midazolam was administered once at a dose of 0.05 mg/kg and with inhalational sedation when N2O was supplied at a concentration of 25?-30%.
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