[Optimal dose of midazolam as premedicant for combined spinal and epidural anesthesia with midazolam sedation].

Sixty patients who underwent simple total hysterectomy under combined spinal and epidural anesthesia with midazolam sedation, were the subjects of a randomized double-blind comparison of intramuscular midazolam 4, 4.5 and 5 mg, and a dose determined by body weight as premedicants. Similar changes in arterial pressure and heart rate were observed. Furthermore sedation and the value of pulse oximetry on arrival were the same. Besides half the patients were amnesic during the procedure of regional approach. However the dose of premedicant was inversely correlated with the maintenance dose. The reduction of pulse oximetry reading on the induction was smaller, while the requirement of vasopressor occurred earlier following the larger dose of premedicant. In spite of the slower induction, the fall of pulse oximetry reading did not decrease. One hour after incision, the reduction of PaO2 was not dose related. In addition count of leucocyte and the level of blood glucose were unchanged. Premedicant determined by body weight was not correlated with the induction dose and amnesic effect. Our findings suggest midazolam 5 mg intramuscularly is the more preferable dose, but careful attention on arterial pressure is required.

RCT Entities:   Population Interventions Outcomes