Effect of different dosages of intravenous midazolam premedication on patients undergoing head and neck surgeries- A double blinded randomized controlled study

Roshni Gupta, Neeta Santha, Madhusudan Upadya, Jesni Joseph Manissery

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. Aim: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). Materials and Methods: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial. The patients were randomized into two main groups, Group 1 receiving 0.02 mg/ kg and Group 2 receiving 0.06 mg/kg midazolam intravenously as premedication. Visual recognition and recall were tested using eight laminated A4 size posters pre-operatively and four further images were shown at the postoperative interview. Anxiety was evaluated by a Visual Analogue Scale (VAS) and sedation depth was determined by the Observer’s Assessment of Alertness/Sedation Scale (OAAS) scale. Vital signs including heart rate, respiratory rate, mean blood pressure and arterial oxygen saturation (SpO2) were monitored. Statistical analysis was done using paired Student's t-test and Chi-square test. Results: VAS scores were lower in Group 2 (0.06 mg/kg) than in Group 1 (0.02 mg/kg) at T15 (15 minutes after the injection of midazolam). Comparison of OAAS scores among Group 1 and Group 2 showed that more patients in Group 1 were alert at T15 compared to Group 2. Recall of events was significantly lower in Group 2 compared to Group 1. There was no significant statistical variation in haemodynamic parameters between the groups except for decreased diastolic blood pressure and room air saturation in Group 2. Conclusion: A higher dosage of midazolam improves the quality of anxiolysis and sedation with lesser rates of intraoperative recall and maintains haemodynamic stability.

Original languageEnglish
Pages (from-to)UC01-UC04
JournalJournal of Clinical and Diagnostic Research
Volume11
Issue number8
DOIs
Publication statusPublished - 01-08-2017

Fingerprint

Premedication
Midazolam
Surgery
Neck
Head
Anxiety
Blood pressure
Hemodynamics
Blood Pressure
Visual Analog Scale
Posters
Amnesia
Vital Signs
Neurology
Chi-Square Distribution
Respiratory Rate
Benzodiazepines
Anesthetics
Statistical methods
Arterial Pressure

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

@article{9c21e36652824ba2aba19c0fabcb4438,
title = "Effect of different dosages of intravenous midazolam premedication on patients undergoing head and neck surgeries- A double blinded randomized controlled study",
abstract = "Introduction: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. Aim: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). Materials and Methods: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial. The patients were randomized into two main groups, Group 1 receiving 0.02 mg/ kg and Group 2 receiving 0.06 mg/kg midazolam intravenously as premedication. Visual recognition and recall were tested using eight laminated A4 size posters pre-operatively and four further images were shown at the postoperative interview. Anxiety was evaluated by a Visual Analogue Scale (VAS) and sedation depth was determined by the Observer’s Assessment of Alertness/Sedation Scale (OAAS) scale. Vital signs including heart rate, respiratory rate, mean blood pressure and arterial oxygen saturation (SpO2) were monitored. Statistical analysis was done using paired Student's t-test and Chi-square test. Results: VAS scores were lower in Group 2 (0.06 mg/kg) than in Group 1 (0.02 mg/kg) at T15 (15 minutes after the injection of midazolam). Comparison of OAAS scores among Group 1 and Group 2 showed that more patients in Group 1 were alert at T15 compared to Group 2. Recall of events was significantly lower in Group 2 compared to Group 1. There was no significant statistical variation in haemodynamic parameters between the groups except for decreased diastolic blood pressure and room air saturation in Group 2. Conclusion: A higher dosage of midazolam improves the quality of anxiolysis and sedation with lesser rates of intraoperative recall and maintains haemodynamic stability.",
author = "Roshni Gupta and Neeta Santha and Madhusudan Upadya and Manissery, {Jesni Joseph}",
year = "2017",
month = "8",
day = "1",
doi = "10.7860/JCDR/2017/26414.10381",
language = "English",
volume = "11",
pages = "UC01--UC04",
journal = "Journal of Clinical and Diagnostic Research",
issn = "2249-782X",
publisher = "Journal of Clinical and Diagnostic Research",
number = "8",

}

Effect of different dosages of intravenous midazolam premedication on patients undergoing head and neck surgeries- A double blinded randomized controlled study. / Gupta, Roshni; Santha, Neeta; Upadya, Madhusudan; Manissery, Jesni Joseph.

In: Journal of Clinical and Diagnostic Research, Vol. 11, No. 8, 01.08.2017, p. UC01-UC04.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of different dosages of intravenous midazolam premedication on patients undergoing head and neck surgeries- A double blinded randomized controlled study

AU - Gupta, Roshni

AU - Santha, Neeta

AU - Upadya, Madhusudan

AU - Manissery, Jesni Joseph

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Introduction: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. Aim: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). Materials and Methods: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial. The patients were randomized into two main groups, Group 1 receiving 0.02 mg/ kg and Group 2 receiving 0.06 mg/kg midazolam intravenously as premedication. Visual recognition and recall were tested using eight laminated A4 size posters pre-operatively and four further images were shown at the postoperative interview. Anxiety was evaluated by a Visual Analogue Scale (VAS) and sedation depth was determined by the Observer’s Assessment of Alertness/Sedation Scale (OAAS) scale. Vital signs including heart rate, respiratory rate, mean blood pressure and arterial oxygen saturation (SpO2) were monitored. Statistical analysis was done using paired Student's t-test and Chi-square test. Results: VAS scores were lower in Group 2 (0.06 mg/kg) than in Group 1 (0.02 mg/kg) at T15 (15 minutes after the injection of midazolam). Comparison of OAAS scores among Group 1 and Group 2 showed that more patients in Group 1 were alert at T15 compared to Group 2. Recall of events was significantly lower in Group 2 compared to Group 1. There was no significant statistical variation in haemodynamic parameters between the groups except for decreased diastolic blood pressure and room air saturation in Group 2. Conclusion: A higher dosage of midazolam improves the quality of anxiolysis and sedation with lesser rates of intraoperative recall and maintains haemodynamic stability.

AB - Introduction: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. Aim: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). Materials and Methods: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial. The patients were randomized into two main groups, Group 1 receiving 0.02 mg/ kg and Group 2 receiving 0.06 mg/kg midazolam intravenously as premedication. Visual recognition and recall were tested using eight laminated A4 size posters pre-operatively and four further images were shown at the postoperative interview. Anxiety was evaluated by a Visual Analogue Scale (VAS) and sedation depth was determined by the Observer’s Assessment of Alertness/Sedation Scale (OAAS) scale. Vital signs including heart rate, respiratory rate, mean blood pressure and arterial oxygen saturation (SpO2) were monitored. Statistical analysis was done using paired Student's t-test and Chi-square test. Results: VAS scores were lower in Group 2 (0.06 mg/kg) than in Group 1 (0.02 mg/kg) at T15 (15 minutes after the injection of midazolam). Comparison of OAAS scores among Group 1 and Group 2 showed that more patients in Group 1 were alert at T15 compared to Group 2. Recall of events was significantly lower in Group 2 compared to Group 1. There was no significant statistical variation in haemodynamic parameters between the groups except for decreased diastolic blood pressure and room air saturation in Group 2. Conclusion: A higher dosage of midazolam improves the quality of anxiolysis and sedation with lesser rates of intraoperative recall and maintains haemodynamic stability.

UR - http://www.scopus.com/inward/record.url?scp=85027270600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027270600&partnerID=8YFLogxK

U2 - 10.7860/JCDR/2017/26414.10381

DO - 10.7860/JCDR/2017/26414.10381

M3 - Article

VL - 11

SP - UC01-UC04

JO - Journal of Clinical and Diagnostic Research

JF - Journal of Clinical and Diagnostic Research

SN - 2249-782X

IS - 8

ER -