title: Effect of intravenous midazolam premedication on postoperative nausea and vomiting after cholecystectomy.
abstract: BACKGROUND
  Several drugs and techniques have been used to reduce the incidence of postoperative nausea and vomiting (PONV). However PONV continues to be a common postoperative complication. Midazolam premedication in pediatric patients has been reported to reduce the incidence of PONV. In the present study the effect of intravenous midazolam premedication on the incidence and severity of PONV was investigated in a sample of adult patients undergoing anesthesia for cholecystectomy.
  
  
  METHODS
  Eighty-two adult patients undergoing general anesthesia for cholecystectomy were randomly divided into two groups to receive either midazolam 75 microg/kg or a same volume of normal saline intravenously fifteen minutes prior to induction of anesthesia. Incidence and severity of PONV together with the total amount of administered metoclopramide during the first postoperative day were compared between two groups.
  
  
  RESULTS
  Severity of nausea was significantly lightened in midazolam group during the first six hours after recovery period compared with placebo group (3.7 +/- 1.6 of a ten point visual analog scale vs. 4.9 +/- 2.2 in placebo group; P < 0.05). Mean number of vomiting episodes was significantly lower in midazolam group (0.4 +/- 0.7 vs. 1.1 +/- 1.4 in placebo group; P < 0.05). Midazolam group received a significantly less amount of metoclopramide during the first postoperative day (2.1 +/- 3.7 mg vs. 5.3 +/- 6.8 mg in placebo group; P < 0.05).
  
  
  CONCLUSIONS
  The results of this study suggest the effectiveness of prophylactic intravenous midazolam premedication to reduce the incidence and severity of postoperative nausea and vomiting. Possible mechanisms for this effect of midazolam may be GABA receptor antagonism, inhibition of dopamine release, and anxiolytic effects.
authors.affiliation: Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seied Morteza
authors.initials: SM
authors.lastname: Heidari
authors.forename: Hamid
authors.initials: H
authors.lastname: Saryazdi
authors.forename: Mahmood
authors.initials: M
authors.lastname: Saghaei
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D002763:Cholecystectomy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011292:Premedication
chemical_list: D000932:Antiemetics; D008874:Midazolam