Anesthesia Medical News about Intravenous Midazolam

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Low Dose Intravenous Midazolam For Prevention Of PONV In Lower Abdominal Surgery - Preoperative vs Intraoperative Administration
Middle East Journal of Anesthesiology, 07/01/09

Safavi MR et al. - The results indicated that midazolam 35 microg/kg (2 mg) given intravenously 30 minutes before the end of surgery was more effective in decreasing the incidence of PONV than midazolam premedication 35 microg/kg.

Exclusive Author Commentary
Mohammad Reza Safavi, 07/02/09

PONV is the most frequent side effect following anesthesia, occurring in about 30% of unselected inpatients and up to 70% of “high-risk impatiens during the 24 h after emergence.Although PONV is almost always self limiting and non-fatal, it can cause significant morbidity, including dehydration, electrolyte imbalance, suture tension and dehiscence, venous hypertension and bleeding, esophageal rupture, and life threatening airway compromise, although the more severe complications are rare. Each vomiting episode delays discharge from the recovery room by about 20 min.The results of our study indicated that patients undergoing lower abdominal surgery under general anesthesia, midazolam 35 µg/kg (2 mg) given intravenously 30 minutes before the end of surgery was more effective than midazolam premedication 35 µg/kg, in decreasing the incidence of PONV without increasing recovery time and the level of sedation. This conclusion is very important in clinical practice and can decrease many complications due to PONV.Further prospective randomized studies with varying doses of midazolam to evaluate its antiemetic properties are needed before drawing any firm conclusions.

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