Midazolam versus propofol for reducing contractility of fatigued canine diaphragm.

The effects of midazolam and propofol on the contractility of fatigued canine diaphragm were examined. Diaphragmatic fatigue was induced by intermittent supramaximal bilateral electrophrenic stimulation at a frequency of 20 Hz applied for 30 min. After fatigue had been induced, group I (n=10) received no study drug, group II (n=10) was given a propofol infusion (0.1 mg kg(-1) loading dose plus 1.5 mg kg(-1) h(-1) maintenance dose) and group III (n=10) was given a midazolam infusion (0.1 mg kg(-1) loading dose plus 0.1 mg kg(-1) h(-1) maintenance dose). Diaphragmatic contractility was assessed by measuring transdiaphragmatic pressure (Pdi). After the fatigue-inducing period in each group, Pdi at low-frequency (20 Hz) stimulation was lower than the baseline values (P<0.05), whereas no change in Pdi at high-frequency (100 Hz) stimulation was observed. In group II, Pdi at 20 Hz stimulation was lower than fatigued values (P<0.05); Pdi at 100 Hz stimulation did not change. In group III, Pdi at both stimulation frequencies was lower than fatigued values (P<0.05). Compared with group I, Pdi at 20 Hz stimulation was lower than fatigued values (P<0.05) during administration of the study drug in groups II and III. The decrease in Pdi was greater in group III than in group II (P<0.05). In conclusion, midazolam compared with propofol is associated with an inhibitory effect on contractility in the fatigued canine diaphragm.