title: A placebo-controlled trial of midazolam as an adjunct to morphine patient-controlled analgesia after spinal surgery.
abstract: OBJECTIVE
  To investigate the potential benefit of postoperatively providing a patient-controlled anxiolytic agent, midazolam, in addition to morphine.
  
  
  METHODS
  A double-blinded, placebo-controlled trial of patient-controlled midazolam.
  
  
  METHODS
  A Community hospital.
  
  
  METHODS
  29 patients undergoing elective spinal surgery.
  
  
  METHODS
  Postoperatively, via two separate patient-controlled pumps, the treatment group received morphine and midazolam, and the control group received morphine and saline solution.
  
  
  METHODS
  Repeated measures using numerical rating scales of the primary outcomes of pain and anxiety were obtained every two hours postoperatively. Amount of morphine and midazolam/placebo administered was assessed, as were other secondary outcomes.
  
  
  RESULTS
  Anxiety level in the treatment group declined more rapidly over the 24 hours after surgery than in the control group. The treatment group used less morphine than the control. Preoperative positive affect was the only significant psychological predictor of postoperative outcomes.
  
  
  CONCLUSIONS
  Patients who received both midazolam and morphine experienced a more rapid decline in anxiety and used less opioid medication than those receiving morphine alone.
authors.affiliation: Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA. Electronic address: day014@crimson.ua.edu.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Day
authors.affiliation: Independent Psychological Practice, Birmingham, AL 35223, USA.
authors.forename: Martha Anne
authors.initials: MA
authors.lastname: Rich
authors.affiliation: Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA.
authors.forename: Beverly E
authors.initials: BE
authors.lastname: Thorn
authors.affiliation: Institute for Health Research and Policy, University of Illinois, Chicago, IL 60608, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berbaum
authors.affiliation: Department of Anesthesiology and Pain Control Services, Northport Medical Center, Northport, AL 35476, USA.
authors.forename: Eugene A
authors.initials: EA
authors.lastname: Mangieri
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D009020:Morphine; D008874:Midazolam
keywords: Anxiety; Midazolam; Morphine; Pain management