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A placebo-controlled trial of midazolam as an adjunct to morphine patient-controlled analgesia after spinal surgery.

Author(s): Day MA(1), Rich MA(2), Thorn BE(3), Berbaum ML(4), Mangieri EA(5).

Affiliation(s): Author information: (1)Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA. Electronic address: day014@crimson.ua.edu. (2)Independent Psychological Practice, Birmingham, AL 35223, USA. (3)Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA. (4)Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA. (5)Department of Anesthesiology and Pain Control Services, Northport Medical Center, Northport, AL 35476, USA.

Publication date & source: 2014, J Clin Anesth. , 26(4):300-8

STUDY OBJECTIVE: To investigate the potential benefit of postoperatively providing a patient-controlled anxiolytic agent, midazolam, in addition to morphine. DESIGN: A double-blinded, placebo-controlled trial of patient-controlled midazolam. SETTING: A Community hospital. PARTICIPANTS: 29 patients undergoing elective spinal surgery. INTERVENTIONS: Postoperatively, via two separate patient-controlled pumps, the treatment group received morphine and midazolam, and the control group received morphine and saline solution. MEASUREMENTS: Repeated measures using numerical rating scales of the primary outcomes of pain and anxiety were obtained every two hours postoperatively. Amount of morphine and midazolam/placebo administered was assessed, as were other secondary outcomes. MAIN RESULTS: Anxiety level in the treatment group declined more rapidly over the 24 hours after surgery than in the control group. The treatment group used less morphine than the control. Preoperative positive affect was the only significant psychological predictor of postoperative outcomes. CONCLUSIONS: Patients who received both midazolam and morphine experienced a more rapid decline in anxiety and used less opioid medication than those receiving morphine alone.

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