title: Can quality of recovery be enhanced by premedication with midazolam?: A prospective, randomized, double-blind study in females undergoing breast surgery.
abstract: BACKGROUND
  Preoperative anxiety is known to be related with the postoperative outcomes, although it remains unclear whether pharmacologic anxiolysis preoperatively leads to better postanesthesia recovery. Hence, the purpose of this study was to assess whether midazolam premedication would result in improved Quality of Recovery-40 survey scores, as a postoperative recovery parameter, in female patients undergoing mastectomy.
  
  
  METHODS
  This randomized double-blind study was performed at Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea. Eighty-two females undergoing breast cancer surgery with propofol-remifentanil anesthesia were enrolled and randomized to receive midazolam 0.02 mg kg (group M) or saline (group C). Anesthesia was conducted with total intravenous anesthesia using propofol and remifentanil. On postoperative day 1, the Quality of Recovery-40 survey scores were surveyed.
  
  
  RESULTS
  The global Quality of Recovery-40 survey scores on postoperative day 1 did not significantly differ between groups M and C (183 vs 181, P = 0.568). However, the induction time was significantly shorter in group M (3.2 vs 4.5 min, P < 0.001), as was the total intraoperative propofol consumption (705 vs 1004 mg; P = 0.022).
  
  
  CONCLUSIONS
  Midazolam premedication does not seem to improve the postoperative quality of recovery, though group M showed faster induction and less propofol consumption.
authors.affiliation: Department of Anesthesiology and Pain Medicine Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea.
authors.forename: Myoung Hwa
authors.initials: MH
authors.lastname: Kim
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae Hi
authors.initials: JH
authors.lastname: Seo
authors.forename: Jeong-Rim
authors.initials: JR
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001007:Anxiety / Q000188:drug therapy*; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery; D004311:Double-Blind Method; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D008408:Mastectomy / Q000379:methods*; D008603:Mental Health; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D011788:Quality of Life; D000077208:Remifentanil; D056910:Republic of Korea; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D008874:Midazolam; D015742:Propofol