A placebo-controlled trial of midazolam as an adjunct to morphine
patient-controlled analgesia after spinal surgery.
Author(s): Day MA(1), Rich MA(2), Thorn BE(3), Berbaum ML(4), Mangieri EA(5).
Affiliation(s): Author information:
(1)Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487,
USA. Electronic address: day014@crimson.ua.edu. (2)Independent Psychological
Practice, Birmingham, AL 35223, USA. (3)Department of Psychology, The University
of Alabama, Tuscaloosa, AL 35487, USA. (4)Institute for Health Research and
Policy, University of Illinois, Chicago, IL 60608, USA. (5)Department of
Anesthesiology and Pain Control Services, Northport Medical Center, Northport, AL
35476, USA.
Publication date & source: 2014, J Clin Anesth. , 26(4):300-8
STUDY OBJECTIVE: To investigate the potential benefit of postoperatively
providing a patient-controlled anxiolytic agent, midazolam, in addition to
morphine.
DESIGN: A double-blinded, placebo-controlled trial of patient-controlled
midazolam.
SETTING: A Community hospital.
PARTICIPANTS: 29 patients undergoing elective spinal surgery.
INTERVENTIONS: Postoperatively, via two separate patient-controlled pumps, the
treatment group received morphine and midazolam, and the control group received
morphine and saline solution.
MEASUREMENTS: Repeated measures using numerical rating scales of the primary
outcomes of pain and anxiety were obtained every two hours postoperatively.
Amount of morphine and midazolam/placebo administered was assessed, as were other
secondary outcomes.
MAIN RESULTS: Anxiety level in the treatment group declined more rapidly over the
24 hours after surgery than in the control group. The treatment group used less
morphine than the control. Preoperative positive affect was the only significant
psychological predictor of postoperative outcomes.
CONCLUSIONS: Patients who received both midazolam and morphine experienced a more
rapid decline in anxiety and used less opioid medication than those receiving
morphine alone.
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