Midazolam premedication improves patient satisfaction in women undergoing general anaesthesia: BMJ
Korea: In women undergoing general anesthesia, premedication with intramuscular midazolam improved satisfaction with the anesthesia experience, with an acceptable safety profile, says a study published in BMJ Open.
Preoperative anxiety is common in patients undergoing surgery. Due to fear of intraoperative awareness, postoperative pain, mortality, and complications such patients are prone to anxiety.
Against the above background, Seung Woo Song, Department of Anesthesiology and Pain Medicine, Wonju Severance Christian Hospital, Wonju, Korea, and colleagues, therefore, aimed to determine the effect of premedication with intramuscular midazolam on patient satisfaction in women undergoing general anesthesia in a double-blind, parallel randomized control trial.
The trial, conducted at a tertiary care medical center in South Korea, initially enrolled 140 women aged 20–65 years who underwent general anesthesia and had an American Society of Anesthesiology physical status classification of I or II. They were randomly assigned to the intervention group or the control group, and the study was completed by 134 patients (intervention n=65; control n=69).
Patients in the intervention group were given intramuscular administration of midazolam (0.05 mg/kg) and those in the control groups were given a placebo (normal saline 0.01 mL/kg) on arrival at the preoperative holding area.
The patient's overall satisfaction with the anesthesia experience as determined by questionnaire responses on the day after surgery was the primary outcome. Satisfaction was defined as a response of 3 or 4 on a five-point scale (0–4). The secondary outcomes included heart rate, blood pressure, recovery duration, oxygen desaturation, and postoperative pain.
Based on the study, the researchers reported the following:
- Patients who received midazolam were more satisfied than those who received a placebo (percentage difference: 21.0%, OR 3.56).
- A subgroup analysis revealed that this difference was greater in patients with anxiety, defined as those whose Amsterdam Preoperative Anxiety and Information Scale anxiety score was ≥11, than that for the whole sample population (percentage difference: 24.0%, OR 4.33).
- Both groups had similar heart rates, blood pressure, and oxygen desaturation.
The researchers concluded, "intramuscular administration of midazolam in women before general anesthesia in the preoperative holding area improved self-reported satisfaction with the anesthesia experience, with minimal risk of associated complications."
Reference:
Song SW, Jin Y, Lim H, et alEffect of intramuscular midazolam premedication on patient satisfaction in women undergoing general anaesthesia: a randomised control trialBMJ Open 2022;12:e059915. doi: 10.1136/bmjopen-2021-059915
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