Anesth Pain Med.  2008 Jan;3(1):22-26.

Small Dose of Midazolam Added to Fentanyl-Ropivacaine for Patient Controlled Epidural Analgesia after Subtotal Gastrectomy

• Kwak K
• Kim S
• Jeon Y
• Suh J
• Kim Y
• Ha J
• Lee S

Abstract

BACKGROUND: Midazolam has been reported to have a spinally mediated antinociceptive effect. In this randomized, double-blind study, we evaluated whether a small dose of midazolam added to fentanyl-ropivacaine mixture for PCEA (patient controlled epidural analgesia) improves epidural analgesia in patients underwent elective subtotal gastrectomy.
METHODS
Forty five patients, ASA physical status I and II, undergoing subtotal gastrectomy were randomly allocated to receive 0.2% ropivacaine mixed with fentanyl 4microg/ml or 0.2% ropivacaine mixed with fentanyl 4microg/ml and midazolam 0.2 mg/ml. The infusion rate was set to deliver 4 ml/hr of the study solution, with a bolus of 2 ml per demand and a 20 minutes lockout time.
RESULTS
Infused volume (P < 0.05) and VAS scores (P < 0.05) was significantly lower in the patients receiving midazolam. However, there were no differences in requiring rescue analgesics, PONV (postoperative nausea and vomiting), sedation scores, urinary retention, and pruritus between groups.
CONCLUSIONS
Small dose of midazolam could augment analgesia without adverse effects when added to thoracic epidural infusion of fentanyl and ropivacaine.

Keyword

fentanyl; midazolam; patient controlled epidural analgesia; ropivacaine

MeSH Terms

Amides
Analgesia
Analgesia, Epidural
Analgesics
Double-Blind Method
Fentanyl
Gastrectomy
Humans
Midazolam
Nausea
Postoperative Nausea and Vomiting
Pruritus
Urinary Retention
Amides
Analgesics
Fentanyl
Midazolam