Midazolam as an antiemetic in patients receiving epidural morphine for postoperative pain relief.

Abstract

PURPOSE:

Epidural morphine has been associated with a significant incidence of postoperative nausea and vomiting (PONV). The authors have evaluated the prophylactic effects of midazolam in preventing nausea and vomiting following epidural morphine for postoperative pain control.

METHODS:

The authors studied 80 women (n = 40 in each group) undergoing total abdominal hysterectomy under epidural anesthesia, in a randomized, double-blind, placebo-controlled study. At the end of the surgery, all patients received epidural morphine 3 mg for postoperative pain. Before morphine injection, the midazolam group received low-dose midazolam infusion (1 mg bolus followed by 1 mg h(-1)), while the placebo group received i.v. saline.

RESULTS:

Patients in the midazolam group reported a lower incidence of total PONV, and a lower frequency of rescue antiemetic request than those in the placebo group (p < 0.05). In addition, midazolam was associated with a reduced incidence of pruritus following epidural morphine (p < 0.05).

CONCLUSION:

The authors conclude that low-dose midazolam infusion is effective in the prevention of nausea, vomiting, and pruritus following epidural morphine for postoperative pain control.

• Authors: Mokhtar Elhakim, Hany Abd-Elfattah, Dalia Nasr El-Din, Reem El-Kabarity, Azia Atef, Atef El-Fakey
• Journal: Journal of opioid management (J Opioid Manag) 2009 Jul-Aug Vol. 5 Issue 4 Pg. 189-95 ISSN: 1551-7489 [Print] United States
• PMID: 19736898 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antiemetics
• Morphine
• Midazolam

Topics

• Adult
• Analgesia, Epidural (adverse effects)
• Antiemetics (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Midazolam (therapeutic use)
• Middle Aged
• Morphine (adverse effects)
• Pain, Postoperative (drug therapy)
• Postoperative Nausea and Vomiting (prevention & control)