Comparison of Effects of Stress and Midazolam on Retrograde and Anterograde Amnesia in Patients Undergoing General Anesthesia.

Anterograde Amnesia General Anesthesia Midazolam Retrograde Amnesia Stress

Journal

Anesthesiology and pain medicine
ISSN: 2228-7531
Titre abrégé: Anesth Pain Med
Pays: Netherlands
ID NLM: 101585412

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 18 12 2022
revised: 23 01 2023
accepted: 24 01 2023
medline: 5 7 2023
pubmed: 5 7 2023
entrez: 5 7 2023
Statut: epublish

Résumé

The identification of different factors affecting anesthesia and physiological changes during anesthesia can be effective in improving the quality of anesthesia. Midazolam is a benzodiazepine that has been used for many years for sedation under anesthesia. Stress is also an important factor affecting memory and other physiological changes, such as blood pressure and heart rate. his study aimed to investigate the effects of stress on retrograde and anterograde amnesia among patients undergoing general anesthesia. This multi-center, parallel, stratified, randomized controlled trial was performed on patients undergoing non-emergency abdominal laparotomy. The patients were divided into high- and low-stress groups according to the Amsterdam Preoperative Anxiety and Information Scale. Then, both groups were randomly divided into three subgroups receiving 0, 0.02, or 0.04 mg/kg of midazolam. Recall cards were shown to patients at 4 minutes, 2 minutes, and immediately before injection to determine retrograde amnesia and at 2 minutes, 4 minutes, and 6 minutes after injection to determine anterograde amnesia. Hemodynamic changes were recorded during intubation. The chi-square and multiple regression tests were used to analyze the data. Midazolam injection was associated with the development of anterograde amnesia in all groups (P < 0.05); however, it had no effect on the development of retrograde amnesia (P < 0.05). Midazolam could decrease the systolic and diastolic blood pressure and heart rate during intubation (P < 0.05). Stress also caused retrograde amnesia in patients (P < 0.05); nevertheless, it had no effect on anterograde amnesia (P > 0.05). Stress and midazolam injection could not affect the oxygen levels during intubation. The results showed that midazolam injection could induce anterograde amnesia, hypotension, and heart rate; nonetheless, it had no effect on retrograde amnesia. Stress was associated with retrograde amnesia and increased heart rate; however, it was not associated with anterograde amnesia.

Sections du résumé

Background UNASSIGNED
The identification of different factors affecting anesthesia and physiological changes during anesthesia can be effective in improving the quality of anesthesia. Midazolam is a benzodiazepine that has been used for many years for sedation under anesthesia. Stress is also an important factor affecting memory and other physiological changes, such as blood pressure and heart rate.
Objectives UNASSIGNED
his study aimed to investigate the effects of stress on retrograde and anterograde amnesia among patients undergoing general anesthesia.
Methods UNASSIGNED
This multi-center, parallel, stratified, randomized controlled trial was performed on patients undergoing non-emergency abdominal laparotomy. The patients were divided into high- and low-stress groups according to the Amsterdam Preoperative Anxiety and Information Scale. Then, both groups were randomly divided into three subgroups receiving 0, 0.02, or 0.04 mg/kg of midazolam. Recall cards were shown to patients at 4 minutes, 2 minutes, and immediately before injection to determine retrograde amnesia and at 2 minutes, 4 minutes, and 6 minutes after injection to determine anterograde amnesia. Hemodynamic changes were recorded during intubation. The chi-square and multiple regression tests were used to analyze the data.
Results UNASSIGNED
Midazolam injection was associated with the development of anterograde amnesia in all groups (P < 0.05); however, it had no effect on the development of retrograde amnesia (P < 0.05). Midazolam could decrease the systolic and diastolic blood pressure and heart rate during intubation (P < 0.05). Stress also caused retrograde amnesia in patients (P < 0.05); nevertheless, it had no effect on anterograde amnesia (P > 0.05). Stress and midazolam injection could not affect the oxygen levels during intubation.
Conclusions UNASSIGNED
The results showed that midazolam injection could induce anterograde amnesia, hypotension, and heart rate; nonetheless, it had no effect on retrograde amnesia. Stress was associated with retrograde amnesia and increased heart rate; however, it was not associated with anterograde amnesia.

Identifiants

pubmed: 37404263
doi: 10.5812/aapm-134300
pmc: PMC10317029
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e134300

Informations de copyright

Copyright © 2023, Author(s).

Déclaration de conflit d'intérêts

Conflict of Interests: The authors declare that they have no competing interests.

Références

Anaesthesia. 2018 Jan;73(1):112-122
pubmed: 29210043
Ann Surg. 2002 Nov;236(5):643-8
pubmed: 12409671
S Afr Med J. 1986 Dec 20;70(13):801-2
pubmed: 3798264
Eur J Psychotraumatol. 2011;2:
pubmed: 22893823
Conscious Cogn. 2014 Jul;27:194-212
pubmed: 24927512
Am J Psychiatry. 2010 Jun;167(6):640-7
pubmed: 20360318
Anesthesiology. 2012 Apr;116(4):946-59
pubmed: 22314293
J Clin Diagn Res. 2017 Aug;11(8):UC01-UC04
pubmed: 28969245
Br J Anaesth. 2007 Apr;98(4):447-55
pubmed: 17329347
J Trauma Dissociation. 2016 Oct-Dec;17(5):593-607
pubmed: 26011396
Brain Nerve. 2018 Jul;70(7):803-812
pubmed: 29997276
Korean J Anesthesiol. 2020 Oct;73(5):361-362
pubmed: 32951409
Br J Anaesth. 2009 Aug;103(2):199-205
pubmed: 19483203
J Oral Maxillofac Surg. 1988 Sep;46(9):746-50
pubmed: 3166044
Br J Oral Maxillofac Surg. 2018 Sep;56(7):632-635
pubmed: 30029983
Anaesthesist. 2008 Jan;57(1):9-30, 32-6
pubmed: 18209969
Neurologist. 2012 Jul;18(4):216-8
pubmed: 22735251
Br J Anaesth. 2005 Mar;94(3):300-5
pubmed: 15567810

Auteurs

Ali Akbar Jafarian (AA)

Department of Anesthesiology and Pain Medicine, Motahari Medical Center, Iran University of Medical Sciences, Tehran, Iran.

Ali Khatibi (A)

Firouzgar General Hospital, Iran University of Medical Sciences, Tehran, Iran.

Mehrdad Mesbah Kiaei (M)

Department of Anesthesiology and Pain Medicine, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Mahmood-Reza Alebouyeh (MR)

Department of Anesthesiology and Pain Medicine, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Mahzad Alimian (M)

Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Azadeh Habibi (A)

Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Saied Amniati (S)

Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Classifications MeSH