One hundred female patients scheduled for elective breast surgery (mean age 60 +/- 11 years were randomly assigned to receive one of two
premedications:
ketobemidone (
Ketogan) 1-1.5 ml or
midazolam 4-5 mg, intramuscularly. The effects on preoperative anxiety and postoperative
emetic sequelae were studied. All patients were anaesthetised with
thiopentone,
fentanyl and
atracurium, and ventilated with a mixture of
nitrous oxide in
oxygen with supplementary
isoflurane. Sixty-nine percent of the
midazolam- and 50% of the
ketobemidone-premedicated patients experienced a reduction in anxiety.
Midazolam was found to be more effective than
ketobemidone in reducing anxiety among more tense patients--those with a VAS grading before
premedication of 2 or more (P less than 0.05).
Midazolam-premedicated patients were also assessed by observers as being more relaxed (P less than 0.05). No difference was seen in the frequency of
emetic sequelae: 20 patients in the
midazolam group and 14 patients in the
ketobemidone group vomited once or more during the 24-h observation period. There was no difference between the two groups in time until an analgetic was required. In conclusion,
midazolam seemed more effective in reducing preoperative anxiety than
ketobemidone without any negative effects on
postoperative emesis or time until an analgetic was required.