2016 年 29 巻 2 号 p. 136-144
With the aim of ensuring safe administration of intravenous sedation with midazolam (MZ), we established an intravenous sedation management system, integrating related devices by a biomedical engineering approach, and applied the system to clinical use. Regarding the dose/dosage regimen of MZ, an infusion software program was created using trustworthy expertise, relevant guidelines and so forth to calculate the clinical dosage/administration. The software not only helps prevent risk in the amount of MZ administered, but also enables the simulation of various conditions. To the Video Overlay Monitoring System (VOLMS) software, which allows the vital signs and electrocardiograms displayed on the monitor to be superimposed on intraoperative images on the display, we added a software program in intravenous sedation mode. This software program allows the total dose infused from the syringe pump, the elapsed time after the end of MZ administration, and the management time to be displayed on the VOLMS display. The system achieves seamless and unified management of the essential information in intravenous sedation that was previously separated in the syringe pump and the monitor. We used the system in clinical practice for implant placement surgery in a 67-year-old woman weighing 61.6 kg. The results showed a total dose of MZ at 5.45 mg in 73 min through the end of the administration. The range of vital sign fluctuations after induction was narrow, largely staying near the preoperative values. Thus, the system with infusion software installed proactively ensures safety in intravenous sedation. Additionally, the images and numerical data recorded in the system supply extremely detailed information for retrospective research studies.
