Opioid sparing effect of post induction intramuscular midazolam following myomectomy

Citation:
Abimbola, J, Adenekan A, Owojuyigbe A, Orji E, Owojuyigbe T, Aaron O.  2020.  Opioid sparing effect of post induction intramuscular midazolam following myomectomy, 2020/10/01. 27:187-195.

Abstract:

Background: Adequate post-operative pain control is essential for smooth recovery after surgery. This study assessed the opioid-sparing effect of immediate post-induction intramuscular midazolam in patients who underwent myomectomy under general anesthesia.Methods: This is a randomized double-blinded controlled study of sixty ASA I and II female patients allocated into three groups. Group A received intramuscular midazolam 0.1mg/kg, group B received intramuscular diclofenac 75mg while group C had a placebo following induction of anesthesia. All patients had morphine 0.1mg/kg for intraoperative analgesia before skin incision. Pain scores were compared at recovery, then at 1st, 2nd, 4th and 8th post-operative hours. In addition, the total opioid consumption over the first 24 hours postoperatively was compared between the three groups.
Results: The pain scores at the end of surgery, 1st and 2nd hours were comparable in the 3 groups; however there was statistically significant difference at the 4th hour postoperatively (p = 0.0001), with lowest pain scores in the midazolam and diclofenac groups (3.70 ± 0.66 and 3.80 ± 1.01 respectively) compared to the placebo group (4.75 ± 0.79). The total additional opioid (pentazocine) consumption in first 24 hour after surgery was significantly reduced in the midazolam group (105.00 ± 15.39 mg) compared to diclofenac and placebo groups (112.50 ± 13.33 mg, and 121.50 ± 18.14 mg respectively, p = 0.007).
Conclusion: Post induction intramuscular Midazolam at 0.1mg/kg appears to have a better opioid sparing effect compared to intramuscular diclofenac 75mg in the early postoperative period
following myomectomy done under general anesthesia.

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