Stephen N. Steen

The effect of diazepam on the respiratory response to carbon dioxide

Summary and ConclusionsSix healthy adult female volunteers were used in the quantitative assessment of their respiratory responses following intravenous administration of meperidine and diazepam. A modified rebreathing CO2-challenge technique of Eckenhoffet al.,5 previously reported,6 was used for this purpose. The CO2 stimulus response curves obtained confirmed the respiratory depressant response following the use of 0.5 mg./kg. meperidine. Diazepam, at dose levels up to 0.066 mg./kg., produced no statistically significant respiratory response to carbon dioxide detectable by this method(p < 0.025).RésuméSix adultes volontaires du sexe féminin et en bonne santé ont servi à l’évaluation quantitative des réactions respiratoires à la suite d’injection intraveineuse de mépéridine et de diazepam. On a utilisé à cet effet une technique modifiée de Eckenhoff et coll., décrite antérieurement.La courbe des réponses obtenues par la stimulation du CO2 a confirmé que l’usage de 0.5 mg./kg. de mépéridine produissait une dépression respiratoire. Le diazepam, à la dose de 0.066 mg./kg., n’a pas produit de réponse de valeur statistique a la stimulation du CO2 en employant cette méthode (p < 0.025).

Effect of diazepam and meperidine, alone and in combination, on respiratory response to carbon dioxide.

METHODS AND MATERIALS The method of study was basically the same as that previously used for investigating the effect of chlordiazepoxide, alone and in combination with meperidine, on the respiratory response to carbon dioxide.7 Fortunately, we had available a ventilatory volume computer,s and thus were able to avoid the laborious individual measurements of tidal volumes for calculation of minute volume.

Investigation of 1,4-benzodiazepine derivatives as basal anesthetic agents.

RAIUQWLIZERS (ataractics) are playing T an increasing role in anesthetic practice. The 1,4-bemodiazepine derivatives belong to a relatively new chemical class, and are not related to the rauwolfia alkaloids, substituted diols, or phenothiazine derivatives. While their effectiveness as tranquilizing agents has been established, their use in clinical anesthesia has not been fully assessed. They have been studied for preoperative sedation1-? and for pharmacologic effects following intravenous administrations*B On the basis of the lack of side effects on the peripheral circulation and on respiration, and the possibility that these drugs might exhibit analgetic properties in larger doses, this investigation was undertaken to evaluate their efficacy as basal anesthetic agents.

effect of OXAZEPAM on respiratory response to CARBON DIOXIDE

ANY m m using the 1,4-benzodiazeM pine derivatives for preoperative sedation have been reported.*-6. While the effectiveness of these drugs as tranquilizing agents has been established, their action on respiratory activity has not been fully assessed. In a continuing examination of such the effect of oxazepam on the respiratory center in woman has been investigated, employing the method of carbon dioxide challenge.

Some pharmacologic effects of intravenous chlordiazepoxide

Effects of intravenous chlordiazepoxide at three dose levels (0.5 mg. per kilogram, 1.0 mg. per kilogram, and 1.5 mg. per kilogram) were studied in 7 conscious volunteers. Meperidine (0.5 mg. per kilogram), pentobarbital sodium (1.0 mg. per kilogram), promethazine (0.5 mg. per kilogram), and a placebo were included for comparison in the study. Evaluation of responses in the postinjection period indicated that (1) promethazine caused the most severe subjective effects, (2) subjects receiving 1.0 mg. per kilogram of chlordiazepoxide appeared to behave as though they had received meperidine or pentobarbital, and (3) there was rw hypotension even at the highest dose level of chlordiazepoxide.

Controlled Evaluation of Parenteral Diazepam as Preanesthetic Medication: A Statistical Study

One sedating agent which has found frequent use within the past few years is a member of the benzodiazepine group, diazepam, which is relatively free of toxic effects. Parked noted that diazepam apparently does not interfere with respiratory response to carbon dioxide, a view we share as a result of our investigations of carbon dioxide challenge to diazepam when administered in high intravenous doses.2 Diazepam has compared favorably with meperidine in patients undergoing minor surgery and laparotomy3 and has been shown to be superior to pentobarbital in calming patients without producing oversedation.4

effects of some PHENOTHIAZINES, with and without MEPERIDINE, on the respiratory response to carbon dioxide

Promethazine (0.5 mg. per kg.) , propiomazine (0.2 mg. per kg.), and chlorpromazine (0.15 mg. per kg.) were administered intravenously separately and in cornbination with meperidine (0.5 mg. per kg.) . Meperidine was also given alone at the same dose level. Thus each volunteer received seven drugs or combinations thereof. RESULTS AND DISCUSSION None of the three phenothiazines tested caused respiratory depression when administered alone (tables 1, 2, and 3). Meperidine produced a consistent respiratory depression for up to 2 hours (p<0.025). Neither chlorpromazine nor promethazine in combination with meperidine resulted in statistically significant respiratory depression.

Anesthetic Considerations in Intracranial Aneurysm Surgery

Rupture of an intracranial aneurysm generally has a poor outcome, though perioperative treatments have improved. At the present time, the important factors in the management of intracranial aneurysm surgery appear to be the maintenance of adequate cerebral perfusion pressure and the avoidance of hyperglycemia. Relevant features of the anesthetic management of this surgery are discussed.