Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting
Multimodal prophylaxis for postoperative nausea and vomiting (PONV) has been recommended, even in low-risk patients. Midazolam is known to have antiemetic properties. We researched the effects of adding midazolam to the dual prophylaxis of ondansetron and dexamethasone on PONV after gynecologic lapa...
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| author | Jiyoung Lee In Kyong Yi Jung Youn Han Eun Duc Na Chunghyun Park Jong Yeop Kim |
| author_facet | Jiyoung Lee In Kyong Yi Jung Youn Han Eun Duc Na Chunghyun Park Jong Yeop Kim |
| author_sort | Jiyoung Lee |
| collection | DOAJ |
| description | Multimodal prophylaxis for postoperative nausea and vomiting (PONV) has been recommended, even in low-risk patients. Midazolam is known to have antiemetic properties. We researched the effects of adding midazolam to the dual prophylaxis of ondansetron and dexamethasone on PONV after gynecologic laparoscopy. In this prospective, randomized, double-blinded trial, 144 patients undergoing gynecological laparoscopic surgery under sevoflurane anesthesia were randomized to receive either normal saline (control group, <i>n</i> = 72) or midazolam 0.05 mg/kg (midazolam group, <i>n</i> = 72) intravenously at pre-induction. All patients were administered dexamethasone 4 mg at induction and ondansetron 4 mg at the completion of the laparoscopy, intravenously. The primary outcome was the incidence of complete response, which implied the absence of PONV without rescue antiemetic requirement until 24 h post-surgery. The complete response during the 24 h following laparoscopy was similar between the two groups: 41 patients (59%) in the control group and 48 patients (72%) in the midazolam group (<i>p</i> = 0.11). The incidence of nausea, severe nausea, retching/vomiting, and administration of rescue antiemetic was comparable between the two groups. The addition of 0.05 mg/kg midazolam at pre-induction to the dual prophylaxis had no additive preventive effect on PONV after gynecologic laparoscopy. |
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| language | English |
| last_indexed | 2024-03-10T05:59:34Z |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-3b99f8c27b4341eb8535bf500b0362012023-11-22T21:03:42ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011021485710.3390/jcm10214857Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and VomitingJiyoung Lee0In Kyong Yi1Jung Youn Han2Eun Duc Na3Chunghyun Park4Jong Yeop Kim5Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, KoreaDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon 16499, KoreaDepartment of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, KoreaDepartment of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, KoreaDepartment of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, KoreaDepartment of Anesthesiology and Pain Medicine, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon 16499, KoreaMultimodal prophylaxis for postoperative nausea and vomiting (PONV) has been recommended, even in low-risk patients. Midazolam is known to have antiemetic properties. We researched the effects of adding midazolam to the dual prophylaxis of ondansetron and dexamethasone on PONV after gynecologic laparoscopy. In this prospective, randomized, double-blinded trial, 144 patients undergoing gynecological laparoscopic surgery under sevoflurane anesthesia were randomized to receive either normal saline (control group, <i>n</i> = 72) or midazolam 0.05 mg/kg (midazolam group, <i>n</i> = 72) intravenously at pre-induction. All patients were administered dexamethasone 4 mg at induction and ondansetron 4 mg at the completion of the laparoscopy, intravenously. The primary outcome was the incidence of complete response, which implied the absence of PONV without rescue antiemetic requirement until 24 h post-surgery. The complete response during the 24 h following laparoscopy was similar between the two groups: 41 patients (59%) in the control group and 48 patients (72%) in the midazolam group (<i>p</i> = 0.11). The incidence of nausea, severe nausea, retching/vomiting, and administration of rescue antiemetic was comparable between the two groups. The addition of 0.05 mg/kg midazolam at pre-induction to the dual prophylaxis had no additive preventive effect on PONV after gynecologic laparoscopy.https://www.mdpi.com/2077-0383/10/21/4857antiemeticsmidazolampostoperative nausea and vomitingprophylaxisgynecologylaparoscopy |
| spellingShingle | Jiyoung Lee In Kyong Yi Jung Youn Han Eun Duc Na Chunghyun Park Jong Yeop Kim Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting Journal of Clinical Medicine antiemetics midazolam postoperative nausea and vomiting prophylaxis gynecology laparoscopy |
| title | Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting |
| title_full | Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting |
| title_fullStr | Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting |
| title_full_unstemmed | Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting |
| title_short | Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting |
| title_sort | effect of adding midazolam to dual prophylaxis for preventing postoperative nausea and vomiting |
| topic | antiemetics midazolam postoperative nausea and vomiting prophylaxis gynecology laparoscopy |
| url | https://www.mdpi.com/2077-0383/10/21/4857 |
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