The effect of intravenous midazolam on persistent postoperative nausea and vomiting (PONV) was compared to placebo in a prospective randomized double-blind study. Twenty patients aged 18 to 82 years with persistent PONV resistant to standard anti-emetics and present for greater than six hours were randomized to receive either an intravenous infusion of midazolam 1.0 mg/h or placebo. Nausea (P=0.04), vomiting (P=0.02) and the use of rescue anti-emetics (P=0.003) were significantly less in the midazolam group. We conclude that low-dose intravenous infusion of midazolam significantly reduces persistent PONV.
CohenM.M., DuncanP.G., DeBoerD.P., TweedW.A.The postoperative interview: Assessing risk factors for nausea and vomiting.Anesth Analg1994; 78: 7–16.
2.
KoivurantaM., LaaraE., SnareL., AlahuhtaS.A survey of postoperative nausea and vomiting.Anaesthesia1997; 52: 443–449.
3.
Hemandez ConteA.T.Postoperative nausea and vomiting: a review of antiemetic pharmacological interventions.Anaesth Pharmacol Physiol Rev1996; 4: 57–65.
4.
AlexanderR., LovellT., SeinguryD., JonesR.M.Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia.Anaesthesia1995; 50: 1086–1088.
5.
OlynykJ.K., CullenS.R., LeahyM.I.Midazolam: an effective antiemetic for cytotoxic chemotherapy.Med J Aust1989; 150: 466.
6.
Di FlorioT.The use of midazolam for persistent postoperative nausea and vomiting.Anaesth Intensive Care1992; 20: 383–386.
7.
KorttilaK.The study of postoperative nausea and vomiting.Br J Anaesth1992; 69: 2OS–23S.
8.
WatchaM.F., WhiteP.F.Postoperative nausea and vomiting.Anesthesiology1992; 77: 162–184.
9.
ForrestJ.B., CahalanM.K., RehderK.. Multicentre study of general anesthesia.Anesthesiology1990; 72: 262–268.
10.
MatsonA., PalazzoM.Postoperative nausea and vomiting. In: Adams AP, Cashman JN, eds.Recent Advances Anesth and Analge1995; 19: 107–126.
11.
GillilandH.E.M., PrasadB.K., MirakhurR.K., FeeJ.P.H.An investigation of the potential morphine sparing effect of midazolam.Anaesthesia1996; 51: 808–811.
12.
EganM., ReadyL.B., NesslyM., GreerB.E.Self-administration of midazolam for postoperative anxiety: a double blinded study.Pain1992; 49: 3–8.
13.
ReidM.S., Herrera-MarschitzM., HokfeltT., TereniusL., UngerstedtU.Differential modulation of striatal dopamine release by intranigral injection of gamma-aminobutyric acid (GABA), dynorphan A and substance P.Eur J Pharmacol1988; 147: 411.
14.
GruenR.J., FreidhoffA.J., CoaleA., MoghaddamB.Tonic inhibition of striatal dopamine transmission: effects of benzodiazepine and GABA A receptor antagonists on extracellular dopamine levels.Brain Res1992; 599: 51.
15.
TakadaK., MuraiT., KanayamaT., KoshikawaN.Effects of midazolam and flunitrazepam on the release of dopamine from rat striatum measured by in vivo microdialysis.Br J Anaesth1993; 70: 181–185.
16.
RackeK., SchworeH., KilbingerH.The pharmacology of 5HT release from enterochromaffin cells. In: ReynoldsW.M., AndrewsP.L.R., DavisC.J., eds. Serotonin and the Scientific Basis of Antiemetic Therapy.Oxford Clinical Communications1995; pp 84–89.
17.
ParkerR.M.C., BentleyK.R., BarnesN.M.Allosteric modulation of 5HT3 receptors: focus on alcohols and anaesthetic agents.Trends Pharmacol Sci1996; 17: 95–99.
18.
Di FlorioT.An update on postoperative nausea and vomiting. In: KeneallyJ., JonesM., eds. Australasian Anaesthesia Australian and New Zealand College of Anaesthetists, Melbourne Vic1996; 155–159.