The Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting

Ahn, Eun Jin; Kang, Hyun; Choi, Geun Joo; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol

doi:10.1213/ane.0000000000001062

Cited by 59 publications

(41 citation statements)

References 29 publications

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“…One week after surgery, the quality of recovery was even higher showing that the patients were recovering from surgery (ERAS protocol) and were almost ready for discharge. Grant et al 12 Ahn et al 13 and Mijderwijk et al 27 described reduced PONV after perioperative administration of midazolam. These effects may improve the quality of recovery.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Moreover, premedication with midazolam lowers the incidence of PONV, which might contribute to a better postoperative experience for patients. 12,13 Nevertheless, whether midazolam improves the overall quality of postoperative recovery is unknown. 14 For example, in two trials, one in ambulatory surgery patients and the other in patients undergoing scheduled inpatient surgery, lorazepam had no beneficial effect on the quality of postoperative recovery and actually resulted in a slower reduction in anxiety and increased aggression after surgery.…”

Section: Résumémentioning

confidence: 99%

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

Beek¹,

Kroon²,

Rijs³

et al. 2019

Can J Anesth/J Can Anesth

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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

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Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

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

Beek¹,

Kroon²,

Rijs³

et al. 2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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“…In the meta-analysis, midazolam premedication resulted in decreasing the incidence and the severity of PONV. [ 26 , 27 ] In our study, intravenous midazolam of 0.03 mg/kg was used in every patient before entering the operation room, which might decrease the incidence of PONV in both groups.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine-remifentanil vs propofol-remifentanil for monitored anesthesia care during hysteroscopy

et al. 2020

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Background: Although dexmedetomidine has been used as either the anesthetic agent for light sedation or as an adjunct to other sedatives, no study has investigated the usefulness of dexmedetomidine as the main sedative agent for invasive and painful procedures. The purpose of this study was to compare the safety of dexmedetomidine-remifentanil and propofol-remifentanil during monitored anesthesia care (MAC) for hysteroscopy. Methods: Female patients undergoing hysteroscopy were randomly assigned to either the dexmedetomidine (group D) or the propofol group (group P). The study drug (0.6 ml/kg; dexmedetomidine 2 μg/ml or propofol 4 mg/ml) was loaded for 10 minutes followed by 0.1 to 0.5 ml/kg/hour to maintain a bispectral index of 60 to 80 during the procedure. In both groups, remifentanil was infused using a target-controlled-infusion system with a target concentration of 2 ng/ml and titrated during the procedure. The incidence rates of intraoperative respiratory depression in both groups were compared. Postoperative pain and patients satisfaction were also compared. Results: A total of 69 female patients were included in this study. Dexmedetomidine significantly decrease the incidence of respiratory depression compared with propofol (15/34 [44.1%] vs 5/35 [14.3%], P = .006, group P and D, respectively). Postoperative pain and patients satisfaction score did not differ between the groups. Conclusion: The combination of dexmedetomidine-remifentanil can reduce the incidence of respiratory depression without increasing hemodynamic complications compared with propofol-remifentanil for MAC during hysteroscopy.

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“…Recently, a large number of RCTs revealed that various drugs prevent PONV [24,25]. Dexamethasone has been used as a preoperative preventive antiemetic for quite some time.…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone for the prevention of postoperative nausea and vomiting in children undergoing non-cardiac surgery: a systematic review and meta-analysis

Shen

Li²,

Zhou

et al. 2019

Preprint

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BACKGROUND: Postoperative nausea and vomiting (PONV) is a frequent and distressing complication of general anaesthesia in paediatric patients. Dexamethasone was reported to prevent PONV in previous randomized controlled trials (RCTs). The purpose of this meta-analysis was to evaluate the role of dexamethasone in the prevention of PONV in children undergoing non-cardiac surgery. METHODS: PubMed, EMBASE, the Cochrane Library, and Web of Science were searched to identify randomized trials that reported the efﬁcacy of perioperative dexamethasone in paediatric non-cardiac surgical patients. RESULTS: Fourteen randomized controlled trials that included 1700 children were included. Compared with placebo, dexamethasone showed a lower incidence of PONV by intravenous injection (RR 0.38, 95% confidence interval (CI) 0.30–0.49) and by local infiltration (RR 0.58, 95% CI 0.34–0.99). The combination of dexamethasone and a 5-HT3 receptor antagonist was more effective than the 5-HT3 antagonist or dexamethasone alone in preventing PONV. CONCLUSION: Perioperative dexamethasone was an effective measure with few complications for preventing PONV in children after non-cardiac surgery.

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The Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting

Abstract: Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.

Cited by 59 publications

References 29 publications

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

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

Dexmedetomidine-remifentanil vs propofol-remifentanil for monitored anesthesia care during hysteroscopy

Dexamethasone for the prevention of postoperative nausea and vomiting in children undergoing non-cardiac surgery: a systematic review and meta-analysis

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