An investigation of the potential morphine sparing effect of midazolam.
The effect of a bolus and continuous infusion of midazolam on postoperative morphine consumption was assessed in a placebo-controlled, double-blind, randomly allocated trial of 50 patients undergoing elective abdominal hysterectomy. Patients in the trial group received a bolus dose of midazolam 5 mg.70 kg-1 at induction followed by an infusion at a rate of 1 mg.70 kg-1.h-1 over the next 48 h. Morphine consumption in the midazolam group was significantly lower in the first 12 h postoperatively (p < 0.02) but there was no significant difference between the two groups thereafter. Patients in the midazolam treated group had lower pain scores over the first 24 h. Also, a significantly greater number of patients in the midazolam group required no antiemetic medication over the 48 h study period (p < 0.05). Assessment of sedation revealed no significant difference between groups. We conclude that low dose midazolam has a significant, but short-lived, morphine sparing effect.
Gilliland
H E
HE
Royal Victoria Hospital, Belfast.
Prasad
B K
BK
Mirakhur
R K
RK
Fee
J P
JP
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy; D007262:Infusions, Intravenous; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*
D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D018757:GABA Modulators; D009020:Morphine; D008874:Midazolam