Postoperative sedation after major surgery with midazolam or propofol in the ICU: effects on amnesia and anxiety.
BACKGROUND
Propofol and midazolam are commonly used in the ICU to alleviate physical and psychological disturbances in consequence of anxiety. This study was conducted to assess and compare the impact of postoperative sedation after major surgery with midazolam or propofol on amnesia and anxiety in conscious patients under intensive care.


METHODS
One hundred and two adult patients irrespective of sex and age, receiving thoracic, abdominal or other major truncal surgery necessitating close care at the ICU, were randomly allocated into midazolam or propofol group. Prior to surgery, all patients were subjected to evaluation of the levels of anxiety and amnesia, which was repeated on the following morning with the level of anxiety and the level of amnesia assessed just before and 30 min after cessation of midazolam or propofol medication, respectively.


RESULTS
There were no significant differences between the two groups regarding gender, age, types of analgesics used, and anxiety. In both groups, the levels of anxiety (P < 0.001) and amnesia (P < 0.001) were improved significantly over the following day. Midazolam had more pronounced effects on amnesia than propofol (P < 0.001). There were no significant differences between the two groups in the pre- or post-drug anxiety (P = 0.189).


CONCLUSIONS
Both midazolam and propofol are effective amnesic and anxiolytic drugs. Midazolam tends to have more favorable effects on amnesia. It is speculated that combination of propofol and midazolam may give better results for treating critically ill ICU patients, the confirmation of which necessitates further study.
Hsiao
Peng-Ching
PC
Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Tang
Yu-Ying
YY
Liaw
Wen-Jinn
WJ
Yue-Cune Chang
Ya-Hsin Lee
YH
Chen
Fa-Chang
FC
Wang
Kwua-Yun
KY
D000328:Adult; D000368:Aged; D000647:Amnesia / Q000139:chemically induced*; D001007:Anxiety / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D007362:Intensive Care Units; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D008875:Middle Aged; D011184:Postoperative Period; D015742:Propofol / Q000494:pharmacology*
D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol