Effect of diluent volume on post-operative analgesia and sedation produced by epidurally administered midazolam.
We have studied the optimal diluent volume for post-operative analgesia and sedation produced by epidurally administered midazolam after upper abdominal surgery. Sixty patients were randomly allocated to four groups of 15 patients. When patients complained of pain after surgery, epidural midazolam 0.05 mg kg-1 in 3 mL saline (Group A), in 5 mL saline (Group B), in 10 mL saline (Group C) or in 15 mL saline (Group D) were injected as a bolus. The sedation was better and lasted longer in groups B and C than in the other two groups. Groups B and C also had significantly more extensive areas of analgesia than groups A and D from 30 min after the administration of midazolam. The interval to the second request for an analgesic was significantly shorter in Group D than in the other three groups. Memory retention of the pin-prick examination was reported by four patients in Group A. The present results indicate that 5-10 mL saline is the optimal volume for epidural injection when using midazolam 0.05 mg kg-1 for post-operative analgesia following upper abdominal surgery.
Nishiyama
T
T
Department of Anesthesiology, University of Tokyo, Faculty of Medicine, Japan.
Hanaoka
K
K
D000005:Abdomen / Q000601:surgery; D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D001364:Awareness / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007268:Injections, Epidural; D008297:Male; D008568:Memory / Q000187:drug effects; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D017288:Pain Threshold / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D014677:Pharmaceutical Vehicles; D012119:Respiration / Q000187:drug effects; D012965:Sodium Chloride / Q000008:administration & dosage*; D013997:Time Factors
D000759:Adjuvants, Anesthesia; D006993:Hypnotics and Sedatives; D014677:Pharmaceutical Vehicles; D012965:Sodium Chloride; D008874:Midazolam