The Effect of Preoperative Injection of Midazolam in the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Ophthalmic Surgery under General Anesthesia

Background: Postoperative nausea and vomiting are common complications that cause patient suffering, increase the length of hospitalization and costs and in severe cases lead to dehydration, electrolyte imbalance, aspiration, pneumonia, and even the surgical site dehiscence. Regarding the previously reported positive effect of midazolam in decreasing this complication, we decided to evaluate its efficacy in patients undergoing ophthalmic surgery under general anesthesia. Methods: The present randomized controlled trial was conducted in 2012 in Feyz Hospital of Isfahan. Our subjects (age range between 18 and 65 years) were candidates for ophthalmic surgery under general anesthesia. Patients were randomly divided into 2 groups: intervention and control. Control group received normal saline and intervention group received midazolam (35 µg/kg) before surgery. The prevalence of the patients’ nausea and vomiting were evaluated and compared between groups on recovery, first, second, third, and fourth 6 hours after surgery. Findings: Nausea and vomiting on recovery (P = 0.02), first (P = 0.028), and second (P = 0.028) 6 hours after surgery were less frequent in midazolam group compared with the control group. Conclusion: According to our results, midazolam has an optimal efficacy in controlling of postoperative nausea and vomiting in patients undergoing ophthalmic surgery under general anesthesia; and in the absence of contraindications, it could be used as a prophylactic treatment in this group of patients. Keywords: Midazolam, Postoperative nausea and vomiting, Ophthalmologic surgical procedures