Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam

查看全文 作　　者：Mitsushige [1]Sugimoto;Takahisa [2]Furuta;Akiko [1]Nakamura;Naohito [3]Shirai;Mutsuhiro [1]Ikuma;Shingen [4]Misaka;Shinya [4]Uchida;Hiroshi [5]Watanabe;Kyoichi [6]Ohashi;Takashi [5]Ishizaki;Akira [1]Hishida 机构地区：[1]First Department of Medicine, Hamamatsu University School of Medicine,1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan;[2]Center for Clinical Research, Hamamatsu University School of Medicine,1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan;[3]Department of Gastroenterology, Enshu General Hospital,1-1-1 Tyuou, Naka-ku, Hamamatsu 430-0929, Japan;[4]Department of Pharmacoki-netics and Pharmacodynamics, School of Pharmaceutics Sciences, University of Shizuoka,52-1 Yada, Suruga-ku, Shizuoka 422-8526, Japan;[5]Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine,1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan;[6]Department of Clinical Pharmacology and Therapeutics, Oita University,1-1 Idaigaoka, Hazama, Yufu 879-5593, Japan 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第33期,共7页 基　　金：Grants-in-Aid for Scientific Research from YOKOYAMA Foundation for Clinical Pharmacology;a Grant-in-Aid from the Center of Excellence (COE) from the Ministry of Education, Culture, Sports, Science and Technology of Japan;Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan No. 17590470 摘　　要：AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP ) 2C19 genotypes after an infusion regimen of diazepam commonly used forgastrointestinal endoscopy in Japan. METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical ? icker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS) symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg). RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively) and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively), which changed significantly compared with the baseline level before infusion (P < 0.05). On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests. CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved. 关 键 词：安定 镇静作用 细胞色素P450 内窥镜检查法 静脉注射