The effect of midazolam as premedication on the quality of postoperative recovery after laparotomy: a randomized clinical trial

Abstract

Purpose Despite the uncertain effects of anxiolytic premedication with benzodiazepines on the quality of postoperative recovery, perioperative benzodiazepine administration is still a common practice in many hospitals. We evaluated the effect of premedication with midazolam on the quality of recovery in hospitalized patients undergoing a laparotomy. Methods We conducted a single-centre randomized placebo-controlled, double-blinded clinical trial from July 2014 to September 2015. We included 192 patients aged [ 18 yr scheduled for elective laparotomy with a planned postoperative stay of C three days. Participants were randomized into two groups to receive either midazolam 3 mg or sodium chloride 0.9% intravenously as premedication prior to surgery. Patients were followed up for up to one week after surgery. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day (POD) 3. The secondary outcomes included the QoR-40 score on POD 7, and the State-Trait Anxiety Inventory, State-Trait Anger Scale, Multidimensional Fatigue Inventory, and the Hospital Anxiety and Depression Scale scores. Results The mean (standard deviation) postoperative QoR-40 scores on POD 3 were not significantly different in the midazolam group compared with controls [166.4 (17.0) vs 163.9 (19.8), respectively; mean difference, 2.3; 95% confidence interval,-2.9 to 8.4; P = 0.35]. There were no between-group differences in any of the secondary outcomes. Conclusions Administration of midazolam as premedication for laparotomy patients did not improve the quality of recovery up to one week after surgery. General prescription of midazolam as premedication can be questioned and might only suit some patients. Trial registration www.clinicaltrials.gov (NCT01993459); registered

Effects of an Informational Video About Anesthesia on Pre- and Post-Elective Cesarean Section Anxiety and Recovery: A Randomized Controlled Trial

“…Bupivacaine-soaked Spongostan, which is an absorbable gelatin powder and hemostatic material, is locally applied in surgical procedures with venous hemorrhage and exudation when traditional homeostasis is difficult, but its application on CS surgical wounds increases the satisfaction rate and decreases postoperative anxiety levels and postpartum depression rates [35]. Although midazolam can reduce the incidence of anxiety, nausea, and vomiting in patients undergoing CS, it has no effect on postoperative recovery [36]. Several antianxiety drugs, such as lorazepam and pregabalin, do not reduce preoperative anxiety and postoperative pain [37,38].…”

Music intervention for sleep quality in critically ill and surgical patients: a meta-analysis

“…19 20 Interventions in the hospital to improve sleep quality mainly include pharmacological interventions, such as benzodiazepines. [21][22][23][24][25] The Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption…”

Eficacia De Los Aceites Esenciales en Comparación Con Benzodiacepinas Para Inducir El Sueño en Personas Sometidas a Cirugía: Una Revisión Rápida

“…4 En las intervenciones de enfermería se pueden utilizar tratamientos no invasivos, baratos, fáciles de aplicar y rentables, que contribuyen a la calidad del sueño de los pacientes; en un estudio el uso de aceite esencial de lavanda aumentó la calidad del sueño y redujo el nivel de ansiedad en pacientes con EAC (Enfermedad Arterial Coronaria). 5 Ciertamente la premedicación es una práctica habitual en los procedimientos quirúrgicos, que impactan en la salud de los pacientes; por ejemplo, la administración perioperatoria de benzodiacepinas sigue siendo una práctica común en muchos hospitales, al comparar la calidad de la recuperación en individuos premedicados; uno de los utilizados es el Midazolam en pacientes hospitalizados sometidos a laparotomía 6 , en otro estudio eligieron Alprazolam y Volumen: 2 Número: 1 Año: 2022 MARZO Midazolam como fármacos de premedicación como método alternativo para mejorar la comodidad preoperatoria del paciente. 3 En respuesta a la problemática mencionada, sobre las afecciones en el sueño en personas que se someten a cirugías se realiza el presente estudio comparando la eficacia del uso de tratamientos naturales con aceites esenciales, utilizados como aromaterapia y/o aplicados, frente al uso de tratamientos farmacológicos como las benzodiacepinas; para la inducción del sueño, en personas mayores de 18 años, sometidas a cirugía con anestesia general.…”