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Antiemetic efficacy of low-dose midazolam in patients undergoing thyroidectomy.

Author(s): Fujii Y, Itakura M

Affiliation(s): Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, Japan. yfujii@med.toho-u.ac.jp

Publication date & source: 2011-02, Otolaryngol Head Neck Surg., 144(2):206-9. Epub 2010 Dec 23.

Publication type: Comparative Study; Randomized Controlled Trial

OBJECTIVE: Postoperative nausea and vomiting are distressing and frequent adverse events of anesthesia and surgery, with a high incidence following thyroidectomy. The aim of this study was to evaluate the efficacy of low-dose midazolam for preventing postoperative nausea and vomiting in patients undergoing thyroidectomy. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: University-affiliated hospital. SUBJECTS AND METHODS: Ninety patients, 30 men and 60 nonpregnant women, received intravenously placebo or midazolam at 2 different doses (50 and 75 microg/kg; n = 30 of each) immediately after induction of anesthesia. A standard general anesthetic technique, including sevoflurane and air in oxygen, was used. Postoperatively, during the first 24 hours after anesthesia, all episodes of nausea and vomiting were recorded and safety assessment were performed. RESULTS: The treatment groups were comparable with regard to patient demographics. The incidence of postoperative vomiting was 17% with midazolam 50 microg/kg (P = .042) and 13% with midazolam 75 microg/kg (P = .019), compared with placebo (40%). No difference in the incidence of postoperative nausea was found among the 3 groups. No clinically important adverse events, such as extrapyramidal signs, were found in any of the groups. None of the patients experienced drowsiness or excessive sedation. CONCLUSION: Midazolam 50 microg/kg is as effective as midazolam 75 microg/kg for preventing postoperative vomiting, but not postoperative nausea, during the first 24 hours after anesthesia in patients undergoing thyroidectomy.

Page last updated: 2011-12-09

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