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

作     者：Mitsushige Sugimoto Takahisa Furuta Akiko Nakamura Naohito Shirai Mutsuhiro Ikuma Shingen Misaka Shinya Uchida Hiroshi Watanabe Kyoichi Ohashi Takashi Ishizaki Akira Hishida 

作者机构：First Department of Medicine Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Center for Clinical Research Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Department of Gastroenterology Enshu General Hospital1-1-1 Tyuou Naka-ku Hamamatsu 430-0929 Japan Department of Pharmacoki-netics and Pharmacodynamics School of Pharmaceutics Sciences University of Shizuoka52-1 Yada Suruga-ku Shizuoka 422-8526 Japan Department of Clinical Pharmacology and Therapeutics Hamamatsu University School of Medicine1-20-1 Handayama Higashi-ku Hamamatsu 431-3192 Japan Department of Clinical Pharmacology and Therapeutics Oita University1-1 Idaigaoka Hazama Yufu 879-5593 Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第33期

页      面：5197-5203页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100217[医学-麻醉学] 10[医学] 

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 

主　　题：Diazepam Sedation cytochrome P450(CYP) 2C19 Endoscopy Complication Critical flicker fusion test Eye movement analysis Postural sway test Visual analog scale 

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.