title: Prospective case control evaluation of epidural midazolam for improving pain and ambulation after microdiscectomy.
abstract: OBJECTIVE
  To evaluate midazolam as an epidural analgesic in patients undergoing single-level microdiscectomy.
  
  
  METHODS
  This prospective case control study was carried out at the Aga Khan University Hospital, Karachi, from January 20 to September 20, 2007, on patients undergoing microdiscectomy. Cases (group A) received midazolam with saline, while controls (group B) received saline only, placed intra-operatively over involved nerve root. Post-operatively, patients were monitored for various variables. Data was analysed using SPSS 13.0 and groups were compared using student's t-test for continuous variables and chi square for categorical variables. P-value <0.05 was considered significant.
  
  
  RESULTS
  Patients in group A ambulated earlier (p = 0.005) and although they did not show significantly better post-operative pain control, but post-operative nausea and vomiting (PONV) score was better at six hours (p = 0.020). There was no difference in other variables such as requirement of analgesics, anti-emetics, hospital stay and complications.
  
  
  CONCLUSIONS
  Midazolam may improve post-operative nausea and vomiting score, and may lead to earlier ambulation, without affecting patient's vitals, consciousness, lower extremity power or sensations, and is not associated with adverse effects.
authors: Section of Neurosurgery, Department of Anesthesia and Pain Management, Aga Khan University Hospital, Karachi.
authors: Muhammad Shahzad
authors: MS
authors: Shamim
authors: Syed Ather
authors: SA
authors: Enam
authors: Muhammad Zubair
authors: MZ
authors: Tahir
authors: Mueenullah
authors: M
authors: Khan
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017586:Diskectomy; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam