Comparison of propofol and midazolam on patients undergoing spinal surgery with intraoperative wake-up test: randomized clinical trial

Background and objectives: Instrumentation in correction operations for spinal deformities carries a 0.5–5% risk of injuring the spinal cord. The wake-up test is used for early detection of these injuries. In this study we compared the effects of propofol and midazolam during wake-up test in scolios...

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Bibliographic Details
Main Authors: Ozgur Canbay, Basak Altiparmak, Nalan Celebi, Heves Karagoz, Fatma Saricaoglu
Format: Article
Language:English
Published: Elsevier 2015-11-01
Series:Brazilian Journal of Anesthesiology
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Online Access:http://www.sciencedirect.com/science/article/pii/S0104001413002030
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Summary:Background and objectives: Instrumentation in correction operations for spinal deformities carries a 0.5–5% risk of injuring the spinal cord. The wake-up test is used for early detection of these injuries. In this study we compared the effects of propofol and midazolam during wake-up test in scoliosis surgery. Methods: Thirty patients were randomly assigned as group P and group M. Anesthesia was induced with propofol 2.5 mg kg−1 for group P or midazolam 0.5 mg kg−1 for group M with remifentanil 0.5 μg kg−1 and cisatracurium 0.15 mg kg−1 for both groups. At the maintenance of anesthesia O2/air and infusions of remifentanil and cisatracurium were used. In group P, propofol 6–10 mg kg−1 h−1 and in group M, midazolam 0.5 mg mg kg−1 were preferred. Approximately 15 min before the wake-up test, all drugs were discontinued. At the wake-up test, anesthesiologist asked the patients to open their eyes and squeeze his/her hand at every 30 s until the patients responded. Then patients were told to wiggle their toes. Hemodynamic parameters, time of eye-opening, appropriate movement upon verbal command were evaluated. BIS frequency throughout the operation was recorded. Results: The eye opening time was 9 ± 2.15 min in group P and 7 ± 3.15 min in group M. Motor movement time was 12 ± 2.55 min in group P and 21.25 ± 3.93 min in group M. Conclusion: Propofol provided better wake-up conditions and conducted a better neurologic assessment within the same BIS values than midazolam.
ISSN:0104-0014