Midazolam as an antiemetic in patients receiving epidural morphine for postoperative pain relief.
OBJECTIVE
Epidural morphine has been associated with a significant incidence of postoperative nausea and vomiting (PONV). The authors have evaluated the prophylactic effects of midazolam in preventing nausea and vomiting following epidural morphine for postoperative pain control.


METHODS
The authors studied 80 women (n = 40 in each group) undergoing total abdominal hysterectomy under epidural anesthesia, in a randomized, double-blind, placebo-controlled study. At the end of the surgery, all patients received epidural morphine 3 mg for postoperative pain. Before morphine injection, the midazolam group received low-dose midazolam infusion (1 mg bolus followed by 1 mg h(-1)), while the placebo group received i.v. saline.


RESULTS
Patients in the midazolam group reported a lower incidence of total PONV, and a lower frequency of rescue antiemetic request than those in the placebo group (p < 0.05). In addition, midazolam was associated with a reduced incidence of pruritus following epidural morphine (p < 0.05).


CONCLUSIONS
The authors conclude that low-dose midazolam infusion is effective in the prevention of nausea, vomiting, and pruritus following epidural morphine for postoperative pain control.
Elhakim
Mokhtar
M
Department of Anaesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Abd-Elfattah
Hany
H
El-Din
Dalia Nasr
DN
El-Kabarity
Reem
R
Atef
Azia
A
El-Fakey
Atef
A
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*
D000932:Antiemetics; D009020:Morphine; D008874:Midazolam