title: Comparison of propofol and midazolam on patients undergoing spinal surgery with intraoperative wake-up test: randomized clinical trial.
abstract: OBJECTIVE
  Instrumentation in correction operations for spinal deformities carries a 0.5-5% risk of injuring the spinal cord. The wake-up test is used for early detection of these injuries. In this study we compared the effects of propofol and midazolam during wake-up test in scoliosis surgery.
  
  
  METHODS
  Thirty patients were randomly assigned as group P and group M. Anesthesia was induced with propofol 2.5 mg kg(-1) for group P or midazolam 0.5 mg kg(-1) for group M with remifentanil 0.5 μg kg(-1) and cisatracurium 0.15 mg kg(-1) for both groups. At the maintenance of anesthesia O2/air and infusions of remifentanil and cisatracurium were used. In group P, propofol 6-10 mg kg(-1)h(-1) and in group M, midazolam 0.5 mg mg kg(-1) were preferred. Approximately 15 min before the wake-up test, all drugs were discontinued. At the wake-up test, anesthesiologist asked the patients to open their eyes and squeeze his/her hand at every 30s until the patients responded. Then patients were told to wiggle their toes. Hemodynamic parameters, time of eye-opening, appropriate movement upon verbal command were evaluated. BIS frequency throughout the operation was recorded.
  
  
  RESULTS
  The eye opening time was 9 ± 2.15 min in group P and 7 ± 3.15 min in group M. Motor movement time was 12 ± 2.55 min in group P and 21.25 ± 3.93 min in group M.
  
  
  CONCLUSIONS
  Propofol provided better wake-up conditions and conducted a better neurologic assessment within the same BIS values than midazolam.
authors.affiliation: Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Canbay
authors.affiliation: Biga State Hospital, Canakkale, Turkey. Electronic address: basakugurlu@me.com.
authors.forename: Basak
authors.initials: B
authors.lastname: Altiparmak
authors.affiliation: Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nalan
authors.initials: N
authors.lastname: Celebi
authors.affiliation: Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Heves
authors.initials: H
authors.lastname: Karagoz
authors.affiliation: Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Saricaoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D002648:Child; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008874:Midazolam / Q000494:pharmacology*; D016343:Monitoring, Intraoperative; D015742:Propofol / Q000494:pharmacology*; D012600:Scoliosis / Q000601:surgery*
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol
keywords: BIS; Cirurgia de coluna; Midazolam; Propofol; Spine surgery; Teste de despertar; Wake-up test