Clinical Observation Of The Effect Of Midazolam On Postoperation Nausea And Vomiting After Gynecological Laparoscopic Surgery

Objective: Through observing the effect of different doses of midazolamon postoperation nausea and vomiting after gynecological laparoscopic surgeryto provide a reference for clinical application.Method: Ninety patients, ASA I~II,18~54years old, BMI less than30were scheduled for gynecological laparoscopic surgery under generalanesthesia. The patients were randomly divided into three groups with30caseseach. Subjects in group M1were given midazolam50μg/kg, and group M2were given midazolam75μg/kg, and group NS were given normal saline. Afterentering operating room, monitoring of ECG、HR、SpO2、BP were carried outon the patients, patients with oxygen mask breathing (4L/min) were performedinduced general anesthesia by intravenous injection with propofol2mg·kg-1,fentanyl3μg·kg-1and cis-atracurium0.15mg·kg-1in turn. Tracheal intubationwas performed after3minutes. Tracheal intubation was followed bymechanical ventilation. Prime setting: breathing rate (f)=12-16times·min-1,VT=8-10mL·kg-1, adjusting f and VT to maintain partial pressure of carbondioxide in endexpiratory gas(PETCO2)30-40mmHg，SpO298%～100%. Afterinduction of anesthesia, three groups respectively received midazolam50μg/kg,midazolam75μg/kg and normal saline. The volume is6mL. Maintenance ofanesthesia is that propofo（l6-10mg·kg-1·h-1）and remifentanil (0.2μg·kg-1·min-1)was administrated by pump infusion during the operations into vein, musclerelaxation was achieved with cis-atracrium as required. Keeping the patientswith stable vital signs and moderate depth of anesthesia, the intravenousinfusion rate is10to15mL·kg-1·h-1. A nasogastric tube was inserted, andsuction was applied to empty the stomach of air and other contents. Before tracheal extubation, the nasogastric tube was again suctioned and then removed.For reversal of muscle relaxation, atropine0.02mg/kg and neostigmine0.04mg/kg were administered intravenously, and the trachea was extubated whenthe patient was awake. All patients were admitted to the post anesthesia careunit after extubation. All episodes of PONV during the first24hours aftersurgery were recorded by an investigator, the investigator was blinded as towhich treatment each patient had received. The investigator questioned thepatients regarding adverse effects and recorded the details. Statistical treatmentis completed with SPSS17.0package. Measurement data is expressed bymean(X)±standard deviation(s), ANOVA and SNK test are used in comparisonwithin the group, Count Data using χ2test, Ranked data using the Wilcoxonrank sum test, P<0.05is considered as statistical significance.Result: The incidence of PONV in Group M1or Group M2wassignificantly lower than the incidence of PONV in group NS (P <0.05). Thereis no statistical significance in the incidence of PONV between Group M1andGroup M2. No clinically important adverse effects due to the study drug wereobserved in any of the groups.Conclusion:1. Midazolam may be effective to prevent PONV in women patientsundergoing the gynecological laparoscopic surgery.2. Midazolam50μg/kg was not significantly different from midazolam75μg/kg in the incidence of PONV after gynecological laparoscopic surgery.