Korean J Anesthesiol.  2006 Nov;51(5):591-597. 10.4097/kjae.2006.51.5.591.

Antiemetic Effect of Midazolam added to Patient-Controlled Analgesia after Total Abdominal Hysterectomy

• Jung SH
• Jeon YH

• KMID: 2034397
• DOI: http://doi.org/10.4097/kjae.2006.51.5.591

Abstract

BACKGROUND: Midazolam has been reported to decrease postoperative nausea and vomiting (PONV). We studied the antiemetic effect of midazolam in patients receiving intravenous patient-controlled analgesia (PCA) using morphine after total abdominal hysterectomy.
METHODS
Group C (n = 27) received bolus of morphine 5 mg and PCA of morphine 1 mg/ml. Group M1 (n = 27) received bolus of morphine 5 mg and midazolam 1 mg and PCA of midazolam 0.2 mg/ml mixed with morphine 1 mg/ml. Group M2 (n = 27) received bolus of morphine 5 mg and midazolam 1 mg and PCA of midazolam 0.4 mg/ml mixed with morphine 1 mg/ml. The PCA delivery system was programmed to deliver 1 ml of the test solution per demand with a 10 min lockout interval and no background infusion. The incidence of PONV, metoclopramide and ketorolac usage, morphine and midazolam consumption, pain, sedation, and other side effects were assessed at 1, 4, 8, 16, 24, 36 and 48 h after the operation.
RESULTS
The incidences of PONV were 19 (70%) in Group C, 14 (52%) in Group M1 and 10 (37%) in Group M2. The incidence of PONV in Group M2 was significantly lower than that in Group C (P < 0.05). Patients in Group M2 experienced more sedation than those in Group C (P < 0.05). No severe sedation was observed in all groups.
CONCLUSIONS
Combination of midazolam 0.4 mg per morphine 1 mg in PCA had more effective antiemetic efficacy than control without significant adverse effects.

Keyword

amidazolam; morphine; patient-controlled analgesia (PCA); postoperative nausea and vomiting (PONV)

MeSH Terms

Analgesia, Patient-Controlled*
Antiemetics*
Humans
Hysterectomy*
Incidence
Ketorolac
Metoclopramide
Midazolam*
Morphine
Passive Cutaneous Anaphylaxis
Postoperative Nausea and Vomiting
Antiemetics
Ketorolac
Metoclopramide
Midazolam
Morphine