Midazolam improves postoperative epidural analgesia with continuous infusion of local anaesthetics

Tomoki Nishiyama, Takeshi Yokoyama, Kazuo Hanaoka

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Purpose: Midazolam has been shown to have an analgesic effect by single shot epidural administration. In this study, the effect of midazolam on continuous epidural infusion of bupivacaine was investigated to find a better combination for postoperative analgesia. Methods: Sixty patients scheduled for gastrectomy were divided into three groups of 20. The following mixtures, in 40 ml, were infused continuously over 12 hr after surgery; 40 ml bupivacaine 0.5% in Group C, bupivacaine 0.5% 38 ml + 10 mg midazolam in Group M10, and bupivacaine 0.5% 36 ml + 20 mg midazolam in Group M20. If necessary, 50 mg indomethacin suppository was administered. Blood pressure, heart rate, respiratory rate, analgesia score, and sedation score were monitored for 12 hr after surgery. Amnesia and frequency of the administration of indomethacin suppository were also noted. Results: Blood pressure, heart rate and respiratory rate showed no differences among the groups. Greater sedation was seen in Groups M10 and M20 compared with Group C during first 120 min (P < 0.05). The number of patients with memory was larger in Group C (18) than in Group M10 (10, P = 0.006) and Group M20 (6, P < 0.001). Better analgesia was obtained in patients receiving midazolam than in Group C (P < 0.05). The frequency of the indomethacin administration was 2.0 ± 1.1 (SD) in Group C, which was larger than in Group M10 (1.1 ± 0.9, P = 0.035) and Group M20 (1.2 ± 0.7, P = 0.039). Conclusion: Adding midazolam to a continuous epidural infusion of bupivacaine provides better analgesia, amnesia and sedation than bupivacaine alone without side effects in patients undergoing laparotomy.

Original languageEnglish
Pages (from-to)551-555
Number of pages5
JournalCanadian Journal of Anaesthesia
Volume45
Issue number6
DOIs
Publication statusPublished - Jan 1 1998

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Epidural Analgesia
Midazolam
Bupivacaine
Local Anesthetics
Analgesia
Indomethacin
Suppositories
Amnesia
Respiratory Rate
Heart Rate
Blood Pressure
Gastrectomy
Laparotomy
Analgesics

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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Midazolam improves postoperative epidural analgesia with continuous infusion of local anaesthetics. / Nishiyama, Tomoki; Yokoyama, Takeshi; Hanaoka, Kazuo.

In: Canadian Journal of Anaesthesia, Vol. 45, No. 6, 01.01.1998, p. 551-555.

Research output: Contribution to journalArticle

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abstract = "Purpose: Midazolam has been shown to have an analgesic effect by single shot epidural administration. In this study, the effect of midazolam on continuous epidural infusion of bupivacaine was investigated to find a better combination for postoperative analgesia. Methods: Sixty patients scheduled for gastrectomy were divided into three groups of 20. The following mixtures, in 40 ml, were infused continuously over 12 hr after surgery; 40 ml bupivacaine 0.5{\%} in Group C, bupivacaine 0.5{\%} 38 ml + 10 mg midazolam in Group M10, and bupivacaine 0.5{\%} 36 ml + 20 mg midazolam in Group M20. If necessary, 50 mg indomethacin suppository was administered. Blood pressure, heart rate, respiratory rate, analgesia score, and sedation score were monitored for 12 hr after surgery. Amnesia and frequency of the administration of indomethacin suppository were also noted. Results: Blood pressure, heart rate and respiratory rate showed no differences among the groups. Greater sedation was seen in Groups M10 and M20 compared with Group C during first 120 min (P < 0.05). The number of patients with memory was larger in Group C (18) than in Group M10 (10, P = 0.006) and Group M20 (6, P < 0.001). Better analgesia was obtained in patients receiving midazolam than in Group C (P < 0.05). The frequency of the indomethacin administration was 2.0 ± 1.1 (SD) in Group C, which was larger than in Group M10 (1.1 ± 0.9, P = 0.035) and Group M20 (1.2 ± 0.7, P = 0.039). Conclusion: Adding midazolam to a continuous epidural infusion of bupivacaine provides better analgesia, amnesia and sedation than bupivacaine alone without side effects in patients undergoing laparotomy.",
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