Antiemetic effect of midazolam compared with the metoclopramida in postoperative surgeries under general anesthesia

Efecto antiemético del Midazolam comparado con la Metoclopramida en postoperatorio de cirugías bajo anestesia general

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Daniel Rivera Tocancipá
Abstract

Objective: To evaluate the antiemetic properties of Midazolam reported in some studies. It was compared to antiemetic Metoclopramida, usually used in our region. 


Method: A double blind randomized clinic trial was designed. It was administered to 126 patients. 


ASA I and II ( between 5 and 60 years old) for elective surgery under general anesthesia with 56 patients; group M (44.4%) was given 50 mcg/kg of Midazolan and 70 group P patients (55.6%) was given 0.2 mg/kg of Metoclopramida administered during the anesthetic induction. It was complemented with Fentanil 3 mcg/kg, tiopental sodico 5 mg/k and bromuro of rocuronio 0.6 mg/kg. The procedure was kept halogenated with the MAC needed to avoid changes in the average blood pressure superior to the 20% of the initial blood pressure. The trial is estimated to reach an alfa error of 0.05, beta error of 0.20. Presence of nausea or vomit during the postoperative period (NVPO) was evaluated for the first six hours and 24 hours after the surgery. 


Results: there were not significant statistically differences between groups (p > 0.05) in relation to the variables such as weight, age, height , sex, and body mass rate. The global incidence of NVPO was of 27.8%, with 20% in the Metocloramida group and 37.5% in the Midazolam group (p=0.02) with a relative risk of 1.88 (IC 95%: 1, 05-3,34). 


Conclusion: The antiemetic effect of Midazolam was not reported. Under general anesthesia, the utilization of Midazolam 0.5 mg/K during the anesthetic induction increased  significantly the incidence of NVPO, with respect to Metoclopramida 0.2 mg/k.


 

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Author Biography / See

Daniel Rivera Tocancipá

Especialista en Epidemiología
References

Onaka M, Yamamoto.Comparison of analgesics used during balanced anesthesia on the incidence of PONV. Masui. 2004; 53(2):161-166.

Gan TJ. Postoperative nausea and vomiting – Can it be elminated?. The Journal of the American Medical Association. 2002; 287(10):1233-1236.

Apfel C. et al. A factorial trial of six interventions for preventing postoperative nausea and vomiting. The New England Journal of Medicine.2002; 350:2441-2451.

Sanjay OP, Tauro DI. Midazolam: An effective antiemetic after cardiac surgery--a clinical trial. Anesthesia & Analgesia. 2004; 99(2):339-343.

Encuesta No. 2 Anestesiología Mexicana en Internet. htpp//www.anestesia.com.mx Tomado en septiembre de 2005.

Golembienski J, Chernin E, Chopra T. Prevention and treatment of postoperative of nausea and vomiting. American Journal of Health.- System Pharmacy.2005; 62:1247-60.

Apfel C. et al. Consensus Guidelines for Managing postoperative nausea and vomiting. Anesthesia & Analgesia. 2003; 97:62-71.

http://www.cica.es/epiinfo/.com. Acceso en septiembre de 2005.

Ardila E, Sánchez R, Echeverri J. Estrategias de Investigación en Medicina Clínica. Ed. Manual Moderno. 2001.

Rodola F. Midazolam as un anti-emetic. European Review for Medical and Pharmacological Sciences. 2006;10(3):121-6.

Jung JS, Park JS, Kim SO, Lim DG, Park SS, Kwak KH, Cho JD, Jeon YH. Prophylactic Antiemetic Effect of Midazolam After Middle Ear Surgery. Otolaryngology- Head &Neck Surgery. 2007; 137(5):753-756.

Timms G. Midazolam Vs Ondastron for Preventing Postoperative Nausea and Vomiting. Anaesthesia. 2007; 62(1):18-22.

Watts JC, Brierley A. Midazolam for treatment of posoperative nausea. Anaesthesia. 2001; 56:1129.

Lariiani GE, Gratz Y, Afshar M, Minassian S. Universidad Surcolombiana - Neiva - Huila 15 investigación original Treatment of Postoperative Nausea and Vomiting With Ondansetron: a Randomized, Double Blind Comparison With Placebo. Anesthesia & Analgesia.1991; 73:246-9.

Pisters KM, Kris MG. Treatment-related nausea and vomiting. In: Berger AM, Portenoy RK, Weissman DE. Principles and practice of supportive oncology. Philadelphia, Pa: Lippincott-Raven Publishers. 1998. 165-199.

Ho KM, Ismail H. Use of intrathecal midazolam to improve perioperative analgesia: a meta-analysis. Anaesthesia and Intensive Care. 2008; 36(3):365-73.

Tarhan O, Canbay O, Celebi N, Uzun S, Sahin A, Coskun F, Aypar U. Subhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for caesarean section. Minerva Anestesiol. 2007; 73(12):629-33.

Di Florio T, Goucke CR. The effect of midazolam on persistent postoperative nausea and vomiting. Anaesthesia and Intensive Care. 1999; 27(1):38-40.

Riad W, Altaf R, Abdulla A, Oudan H. effect of midazolam, dexametasone and their combination on the prevention of náusea and vomiting following strabismus repair in children. European Journal of Anaesthesiology.2007; 24(8):697-701.

Gibson RM, Prentice EK, Martin L, Mayson KV. Prophylaxis and treatment of postoperative nausea and vomiting (PONV). Canadian Journal of Anesthesia; A70. 2005.

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