IMMUNOLOGIC PROFILE CHANGES IN PATIENTS EXPERIENCING AMNESIA DURING CONSCIOUS SEDATION (MIDAZOLAM, ANXIETY).
Contributors: University of Pennsylvania.
Published: 1996
Number of pages: 86
Subjects: Health Sciences, Nursing.; Health Sciences, Immunology.; Psychology, Physiological.; Health Sciences, Medicine and Surgery.
Description: Conscious sedation, with amnesia producing drugs such as midazolam, is commonly used as an anesthetic technique to help patients cope with uncomfortable and anxiety provoking diagnostic procedures. Advances in the field of psychoneuroimmunology have established bidirectional connections between the brain and the immune system. The study examines the relationships between the amnesia produced by conscious sedation in patients receiving midazolam and immune profile changes.

This was a prospective study of two groups of patients having either colonoscopies or sigmoidoscopies, consisting of 12 patients in each group. The colonoscopy group received conscious sedation and all experienced amnesia. The sigmoidoscopy group received no conscious sedation and none experienced amnesia. The groups were equivalent for age, concomitant medical conditions, medications currently taken, sleep, nicotine and caffeine. Patients had blood drawn for complete blood count and determination of CD3, CD4, CD8 and CD45 prior to the procedure, after the procedure and at a home visit three days later. Anxiety was assessed with the Multiple Affect Adjective Check List at each of the same three time points. The Common Recorded Sound Test was administered to each subject prior to the start of the diagnostic procedure and five minutes after sedation began in the colonoscopy group and at the end of the procedure in both groups.

The complete blood counts revealed differences between the groups with respect to neutrophils (colonoscopy group higher) and monocytes (sigmoidoscopy group higher). Differences in the patterns of change in CD3 and CD4 over time were found between the groups, however these differences became insignificant when anxiety was used as a covariate. The pattern of change in anxiety over time was different for the groups and when the subjects were divided into groups based on pre-procedure anxiety scores, differences between groups were found in the CD3 and CD4 markers. Anxiety was found to be the more significant predictor of changes in immune profile between these groups. It is concluded that conscious sedation may be beneficial to patients undergoing diagnostic procedures by helping to reduce anxiety rapidly. Measures to further reduce anxiety in these patients may reduce changes in immune profile.
Notes: Source: Dissertation Abstracts International, Volume: 57-04, Section: B, page: 2476.

Thesis (PH.D.)--UNIVERSITY OF PENNSYLVANIA, 1996.

School code: 0175.