{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:20:09Z","timestamp":1788171609027,"version":"build-2803163510"},"reference-count":26,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Intravenous sedation with propofol is often administered to anxious patients in dental practice. Pain on injection of propofol is a common adverse effect. This study aimed to determine the age-adjusted doses of midazolam required to erase memory of vascular pain of propofol administration and assess whether the Ramsay Sedation Scale (RSS) after the pretreatment of midazolam was useful to predict amnesia of the vascular pain of propofol administration. A total of 246 patients with dental phobia requiring dental treatment under intravenous sedation were included. Patients were classified according to their age: 30s, 40s, 50s, and 60s. Three minutes after administration of a predetermined dose of midazolam, propofol was infused continuously. After completion of the dental procedure, patients were interviewed about the memory of any pain or discomfort in the injection site or forearm. The dosage of midazolam was determined using the Dixon up-down method. The first patient was administered 0.03 mg\/kg, and if memory of vascular pain remained, the dosage was increased by 0.01 mg\/kg for the next patient, and then if the memory was erased, the dosage was decreased by 0.01 mg\/kg. The effective dosage of midazolam in 95% of each age group for erasing the memory of propofol vascular pain (ED<jats:sub>95<\/jats:sub>) was determined using logistic analysis. The accuracy of RSS to predict the amnesia of injection pain was assessed by receiver operating characteristic (ROC) analysis. The ED<jats:sub>95<\/jats:sub> of midazolam to erase the memory of propofol vascular pain was 0.061 mg\/kg in patients in their 30s, 0.049 mg\/kg in patients in their 40s, 0.033 mg\/kg in patients in their 50s, and 0.033 mg\/kg in patients in their 60s. The area under the ROC curve was 0.31. The ED<jats:sub>95<\/jats:sub> of midazolam required to erase the memory of propofol vascular pain demonstrated a downward trend with age. On the other hand, it was impossible to predict the amnesia of propofol vascular pain using the RSS.<\/jats:p>","DOI":"10.2344\/15-00034.1","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T20:25:08Z","timestamp":1472761508000},"page":"147-155","source":"Crossref","is-referenced-by-count":6,"title":["Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration"],"prefix":"10.2344","volume":"63","author":[{"given":"Aiji","family":"Boku","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Aichi Gakuin University School of Dentistry, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Hanamoto","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiko","family":"Oyamaguchi","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiho","family":"Kudo","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsutaka","family":"Sugimura","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Niwa","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-63-3-147-b01","series-title":"Drugs","first-page":"513","article-title":"Propofol. 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J Clin Anesth (Jpn). 2003;27:1725\u20131730."},{"key":"i0003-3006-63-3-147-b04","series-title":"Anesth Analg","first-page":"963","article-title":"Prevention of pain on injection with propofol: a quantitative systematic review","volume":"90","author":"Picard \n              P,","year":"2000","unstructured":"Picard \n              P, \n            \n            \n              Tram\u00e8r \n              MR. \n            \n          \n          Prevention of pain on injection with propofol: a quantitative systematic review. 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Clin Pharmacol Ther. 1998;63:552\u2013560."},{"key":"i0003-3006-63-3-147-b10","series-title":"Anesth Analg","first-page":"143","article-title":"Aging increases pharmacodynamic sensitivity to the hypnotic effects of midazolam","volume":"80","author":"Jacobs \n              JR,","year":"1995","unstructured":"Jacobs \n              JR, \n            \n            \n              Reves \n              JG, \n            \n            \n              Marty \n              J, \n            \n            \n              White \n              WD, \n            \n            \n              Bai \n              SA, \n            \n            \n              Smith \n              LR. \n            \n          \n          Aging increases pharmacodynamic sensitivity to the hypnotic effects of midazolam. Anesth Analg. 1995;80:143\u2013148."},{"key":"i0003-3006-63-3-147-b11","series-title":"Approved by ASA House of Delegates on October 13, 1999, and last amended on October 15, 2014","article-title":"Continuum of depth of sedation: definition of general anesthesia and levels of sedation\/analgesia","year":"2014","unstructured":"American Society of Anesthesiologists. Continuum of depth of sedation: definition of general anesthesia and levels of sedation\/analgesia. Approved by ASA House of Delegates on October 13, 1999, and last amended on October 15, 2014. Schaumburg, Ill.: American Society of Anesthesiologists; 2014."},{"key":"i0003-3006-63-3-147-b12","series-title":"Neurosci Biobehav Rev","first-page":"47","article-title":"Staircase bioassay: the up-and-down method","volume":"15","author":"Dixon \n              WJ.","year":"1991","unstructured":"Dixon \n              WJ. \n            \n          \n          Staircase bioassay: the up-and-down method. 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J Clin Anesth (Jpn). 2004;10:1657\u20131661."},{"key":"i0003-3006-63-3-147-b15","series-title":"Science","first-page":"248","article-title":"Memory\u2014a century of consolidation","volume":"287","author":"McGaugh \n              JL.","year":"2000","unstructured":"McGaugh \n              JL. \n            \n          \n          Memory\u2014a century of consolidation. Science. 2000;287:248\u2013251."},{"key":"i0003-3006-63-3-147-b16","series-title":"Seishin Igaku","first-page":"361","article-title":"Obstacle of short-term memory by record benzodiazepine medicine manufacturing (triazolam)","volume":"23","author":"Hazama \n              H,","year":"1981","unstructured":"Hazama \n              H, \n            \n            \n              Kawahara \n              T. \n            \n          \n          Obstacle of short-term memory by record benzodiazepine medicine manufacturing (triazolam). 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Masui. 1996;45:593\u2013598."},{"key":"i0003-3006-63-3-147-b18","series-title":"Dig Dis Sci","first-page":"1291","article-title":"Incidence of propofol injection pain and effect of lidocaine pretreatment during upper gastrointestinal endoscopy","volume":"57","author":"Kwon \n              JS,","year":"2012","unstructured":"Kwon \n              JS, \n            \n            \n              Kim \n              ES, \n            \n            \n              Cho \n              KB, \n            \n            et al. \n          Incidence of propofol injection pain and effect of lidocaine pretreatment during upper gastrointestinal endoscopy. 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Clin Pharmacol. 1987;23:703\u2013708."},{"key":"i0003-3006-63-3-147-b20","series-title":"Masui","first-page":"803","article-title":"The use of low dose midazolam for the management of spinal anesthesia","volume":"46","author":"Nagahama \n              H,","year":"1997","unstructured":"Nagahama \n              H, \n            \n            \n              Okada \n              Y, \n            \n            \n              Kinouchi \n              H, \n            \n            \n              Tateda \n              T, \n            \n            \n              Aoki \n              T, \n            \n            \n              Morokawa \n              Y. \n            \n          \n          The use of low dose midazolam for the management of spinal anesthesia. 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J Anesth. 2009;23:329\u2013333."},{"key":"i0003-3006-63-3-147-b24","series-title":"Endoscopy","first-page":"239","article-title":"Synergistic sedation with low-dose midazolam and propofol for colonoscopies","volume":"32","author":"Reimann \n              FM,","year":"2000","unstructured":"Reimann \n              FM, \n            \n            \n              Samson \n              U, \n            \n            \n              Derad \n              I, \n            \n            \n              Fuchs \n              M, \n            \n            \n              Schiefer \n              B, \n            \n            \n              Stange \n              EF. \n            \n          \n          Synergistic sedation with low-dose midazolam and propofol for colonoscopies. Endoscopy. 2000;32:239\u2013244."},{"key":"i0003-3006-63-3-147-b25","series-title":"Dig Liver Dis","first-page":"81","article-title":"Target-controlled infusion during monitored anesthesia care in patients undergoing EUS: propofol alone versus midazolam plus propofol. A prospective double-blind randomized controlled trial [published online ahead of print October 16, 2006]","volume":"39","author":"Fanti \n              L,","year":"2007","unstructured":"Fanti \n              L, \n            \n            \n              Agostoni \n              M, \n            \n            \n              Arcidiacono \n              PG, \n            \n            et al. \n          Target-controlled infusion during monitored anesthesia care in patients undergoing EUS: propofol alone versus midazolam plus propofol. A prospective double-blind randomized controlled trial [published online ahead of print October 16, 2006]. Dig Liver Dis. 2007;39:81\u201386."},{"key":"i0003-3006-63-3-147-b26","series-title":"Aliment Pharmacol Ther","first-page":"1207","article-title":"Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study","volume":"14","author":"Seifert \n              H,","year":"2000","unstructured":"Seifert \n              H, \n            \n            \n              Schmitt \n              TH, \n            \n            \n              G\u00fcltekin \n              T, \n            \n            \n              Caspary \n              WF, \n            \n            \n              Wehrmann \n              T. \n            \n          \n          Sedation with propofol plus midazolam versus propofol alone for interventional endoscopic procedures: a prospective, randomized study. Aliment Pharmacol Ther. 2000;14:1207\u20131214."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/63\/3\/article-p147.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/63\/3\/147\/2101323\/15-00034_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/63\/3\/article-p147.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/63\/3\/article-p147.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:36:26Z","timestamp":1728304586000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/63\/3\/article-p147.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":26,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2344\/15-00034.1","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"value":"0003-3006","type":"print"},{"value":"1878-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}