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In vitro changes in the transparency and pH of cerebrospinal fluid caused by adding midazolam

Published online by Cambridge University Press:  16 August 2006

T. Nishiyama ,
N. Sugai  and
K. Hanaoka
T. Nishiyama
Affiliation:
Department of Anesthesiology, Faculty of Medicine, The University of Tokyo 7-3-1, Hongo, Bunko-ku, Tokyo, 113 Japan Present address: Department of Anesthesiology, Harbor-University of California, Los Angeles, 1000 West Carson Street, Torrance, CA 90509, USA
N. Sugai
Affiliation:
Department of Anesthesiology, Faculty of Medicine, The University of Tokyo 7-3-1, Hongo, Bunko-ku, Tokyo, 113 Japan Present address: Department of Anesthesiology, Harbor-University of California, Los Angeles, 1000 West Carson Street, Torrance, CA 90509, USA
K. Hanaoka
Affiliation:
Department of Anesthesiology, Faculty of Medicine, The University of Tokyo 7-3-1, Hongo, Bunko-ku, Tokyo, 113 Japan Present address: Department of Anesthesiology, Harbor-University of California, Los Angeles, 1000 West Carson Street, Torrance, CA 90509, USA
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Abstract

The effects of adding midazolam and bupivacaine to human cerebrospinal fluid in glass test tubes were examined by looking for changes in pH and a reduction in the transparency of the solution. Midazolam (n=6), 0.25% bupivacaine (n=6), 5 mg of midazolam in 6 mL of 0.25% bupivacaine (n=6) and 5 mg of midazolam in 10 mL of saline (n=6) were added to 1.5-mL samples (n=24) of cerebrospinal fluid taken at the time spinal anaesthesia was begun. Transparency and pH were checked after each increment. Cerebrospinal pH was decreased to below 7.0 by adding more than 3 mg of midazolam, more than 1.9 mL of 0.25% bupivacaine or 1.3 mL of the mixture. Cerebrospinal transparency was decreased by adding more than 0.7 mg of midazolam, 1.1 mL of 0.25% bupivacaine or 0.6 mL of the mixture. Midazolam in saline neither decreased the pH below 7.0 nor reduced transparency. These results do not suggest that clinically useful doses of intrathecal or epidural midazolam are neurotoxic.

Keywords

cerebrospinal fluidin vitro changesmidazolam
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 15 , Issue 1 , January 1998 , pp. 27 - 31
Copyright
1998 European Society of Anaesthesiology

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