The Experts below are selected from a list of 114 Experts worldwide ranked by ideXlab platform
Markus C. Schneider - One of the best experts on this subject based on the ideXlab platform.
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Preoperative anxiolysis with minimal sedation in elderly patients: bromazepam or Clorazepate‐Dipotassium?
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
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preoperative anxiolysis with minimal sedation in elderly patients bromazepam or Clorazepate Dipotassium
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: T Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
Kenji Sugai - One of the best experts on this subject based on the ideXlab platform.
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Cardio-facio-cutaneous syndrome with infantile spasms and delayed myelination.
Brain & development, 2010Co-Authors: Koichi Aizaki, Kenji Sugai, Eiji Nakagawa, Yoshiaki Saito, Masayuki Sasaki, Yoko Aoki, Yoichi MatsubaraAbstract:Abstract A girl with cardio-facio-cutaneous (CFC) syndrome due to a BRAF gene mutation (c.1454T→C, p.L485S) experienced repetitive epileptic spasms at the corrected age of 4 months. Electroencephalograms revealed hypsarrhythmia, and magnetic resonance imaging identified delayed myelination and a hypoplastic corpus callosum. Various antiepileptic treatments, including adrenocorticotropic hormone therapy, were ineffective, although transient seizure control was achieved by a ketogenic diet and Clorazepate Dipotassium. However, seizures with epileptic foci at the bilateral posterior temporal areas re-aggravated and remained intractable; severe psychomotor delay persisted. This case indicated that infantile spasms in CFC syndrome can be difficult to control and may be accompanied by severe psychomotor retardation and abnormal myelination.
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a case of refractory complex partial seizure status epilepticus that dramatically responded to Clorazepate Dipotassium
Journal of The Japan Epilepsy Society, 2009Co-Authors: Yuko Shimizu, Kenji Sugai, Eiji Nakagawa, Yoshiaki Saito, Hirofumi Komaki, Hiroshi Sakuma, Masayuki Sasaki, Rie MiyataAbstract:精神運動発達遅滞とWest症候群を呈した女児で、幼児期より非けいれん性てんかん発作を生じるようになった。6歳時に意識減損、目つきがかわる、頭部前屈する非けいれん性重積発作を繰り返した。脳波で律動性高振幅θ波が両側前頭、中心部優位に群発し、脳血流SPECTで左前頭部から頭頂部、左尾状核と被殻の血流増加を認めた。複雑部分発作重積と診断したが薬物抵抗性であり、midazolamの持続静注から離脱困難となった。Benzodiazepine系薬剤の中でもclonazepamやclobazamは効果がなかったが、Clorazepate投与にて発作はほぼ消失し、3カ月間のmidazolam持続静注療法から離脱することができた。3カ月後現在も発作はほぼ認められない。Clorazepateの特性として、局在関連てんかんでの有効性や抗不安作用による発作改善の可能性が過去に指摘されており、本症例でClorazepateが有効であった理由と考えられる。
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Clobazam as a new antiepileptic drug and Clorazepate Dipotassium as an alternative antiepileptic drug in Japan.
Epilepsia, 2004Co-Authors: Kenji SugaiAbstract:Summary: Purpose: To confirm the efficacy and to clarify the problems of clobazam (CLB) as a new antiepileptic drug (AED) and Clorazepate (CLP) as an alternative AED in Japan. Methods: CLB and CLP were added on or replaced with conventional AEDs in 55 and 170 patients with refractory epilepsies, respectively. Short-term efficacy was studied after at least 2 months of CLB administration and at least 4 weeks of CLP administration. Long-term efficacy was examined in 31 cases with CLB for ≥6 months and in 86 cases with CLP for ≥6 months. CLB was initiated at 0.15–0.40 mg/kg and increased by 0.1–0.2 mg/kg every 1–2 weeks up to 0.28–1.25 mg/kg. CLP was started at 0.3–0.7 mg/kg and increased by 0.2–0.3 mg/kg every 1–2 weeks up to 2.5 mg/kg. Tolerance was examined in 42 cases with CLB for ≥3 months and 112 cases with CLP for ≥4 weeks. Results: CLB was effective, defined as ≥50% reduction in seizure frequency, in 71% of the short-term subjects and 81% of the long-term subjects. Short-term efficacy was better in symptomatic localization-related epilepsies, but long-term efficacy did not differ according to seizure classification. Short-term efficacy was not different by seizure types or EEG findings. CLP was effective in 70% of the short-term subjects and 80% of the long-term subjects. CLP was more effective in patients with localization-related epilepsies or in patients with partial seizures or focal epileptiform discharges on EEG. Adverse effects developed in 47% of CLB cases and 31% of CLP cases, but the incidence was reduced by lower initial doses and slow dose titration. Tolerance occurred in 24% of CLB cases and 48% of CLP cases, half within 3–4 months after the initiation of CLB and half by 2 months after the start of CLP. Upon rechallenge, 70% of CLB-tolerant cases and 50% of CLP-tolerant cases responded to each drug again by increasing or maintaining the dosage. Conclusions: Excellent efficacy of CLB and excellent and prolonged efficacy of CLP for refractory epilepsies were confirmed. Frequent tolerance and adverse effects were major problems, but were manageable.
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Clobazam as a new antiepileptic drug and Clorazepate Dipotassium as an alternative antiepileptic drug in Japan.
Epilepsia, 2004Co-Authors: Kenji SugaiAbstract:To confirm the efficacy and to clarify the problems of clobazam (CLB) as a new antiepileptic drug (AED) and Clorazepate (CLP) as an alternative AED in Japan. CLB and CLP were added on or replaced with conventional AEDs in 55 and 170 patients with refractory epilepsies, respectively. Short-term efficacy was studied after at least 2 months of CLB administration and at least 4 weeks of CLP administration. Long-term efficacy was examined in 31 cases with CLB for > or =6 months and in 86 cases with CLP for > or =6 months. CLB was initiated at 0.15-0.40 mg/kg and increased by 0.1-0.2 mg/kg every 1-2 weeks up to 0.28-1.25 mg/kg. CLP was started at 0.3-0.7 mg/kg and increased by 0.2-0.3 mg/kg every 1-2 weeks up to 2.5 mg/kg. Tolerance was examined in 42 cases with CLB for > or =3 months and 112 cases with CLP for > or =4 weeks. CLB was effective, defined as > or =50% reduction in seizure frequency, in 71% of the short-term subjects and 81% of the long-term subjects. Short-term efficacy was better in symptomatic localization-related epilepsies, but long-term efficacy did not differ according to seizure classification. Short-term efficacy was not different by seizure types or EEG findings. CLP was effective in 70% of the short-term subjects and 80% of the long-term subjects. CLP was more effective in patients with localization-related epilepsies or in patients with partial seizures or focal epileptiform discharges on EEG. Adverse effects developed in 47% of CLB cases and 31% of CLP cases, but the incidence was reduced by lower initial doses and slow dose titration. Tolerance occurred in 24% of CLB cases and 48% of CLP cases, half within 3-4 months after the initiation of CLB and half by 2 months after the start of CLP. Upon rechallenge, 70% of CLB-tolerant cases and 50% of CLP-tolerant cases responded to each drug again by increasing or maintaining the dosage. Excellent efficacy of CLB and excellent and prolonged efficacy of CLP for refractory epilepsies were confirmed. Frequent tolerance and adverse effects were major problems, but were manageable.
Wolfgang Ummenhofer - One of the best experts on this subject based on the ideXlab platform.
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Preoperative anxiolysis with minimal sedation in elderly patients: bromazepam or Clorazepate‐Dipotassium?
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
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preoperative anxiolysis with minimal sedation in elderly patients bromazepam or Clorazepate Dipotassium
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: T Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
Karl F. Hampl - One of the best experts on this subject based on the ideXlab platform.
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Preoperative anxiolysis with minimal sedation in elderly patients: bromazepam or Clorazepate‐Dipotassium?
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
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preoperative anxiolysis with minimal sedation in elderly patients bromazepam or Clorazepate Dipotassium
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: T Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
M. Sluga - One of the best experts on this subject based on the ideXlab platform.
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Preoperative anxiolysis with minimal sedation in elderly patients: bromazepam or Clorazepate‐Dipotassium?
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.
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preoperative anxiolysis with minimal sedation in elderly patients bromazepam or Clorazepate Dipotassium
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: T Erb, M. Sluga, Karl F. Hampl, Wolfgang Ummenhofer, Markus C. SchneiderAbstract:Background: In elderly patients undergoing ophthalmic surgery the loss of co-operation due to over-sedation, induced by drugs given preoperatively, may jeopardise the success of microsurgery performed under regional anaesthesia. The aim of this study was to compare the psychotropic effects of bromazepam and Clorazepate-Dipotassium, two benzodiazepines with predominantly anxiolytic and only weak sedative action. Methods: A randomised, placebo-controlled, double-blind study was designed to include 60 patients, ASA physical status II-III, older than 60 years scheduled for ophthalmic surgery under regional anaesthesia. The patients were randomised to receive either bromazepam (3 mg) or Clorazepate-Dipotassium (20 mg) or placebo. The study drugs were given at 10 p.m. the night before surgery and 90 min before surgery. Using the State-Trait Anxiety Inventory (STAI), the patient's anxiety was assessed at the end of the preoperative visit, on the next morning before the study drug was given and on arrival at the operating theatre. Results: Bromazepam induced a marked anxiolytic effect as documented by a significant reduction in the STAI State values after both applications (P0.01). Clorazepate did not differ from placebo at any evaluation time with regard to the STAI and haemodynamic values. Sedative effects and oxygen saturation (SpOz) were comparable in all groups. Conclusion: Bromazepam is superior to Clorazepate in its anxiolytic action and suitable as preoperative medication in the elderly patient because of lack of overt sedative effects.