Midazolam versus diazepam as premedication for gynaecologic laparoscopy done under local anaesthesia

ABSTRACT

A prospective randomised double blind trial was performed in 106 patients to compared the use of intravenous midazolam (mean dose 6.5 mg, range 4-9 mg) versus 10 mg diazepam, during gynaecologic laparoscopy under local anaesthesia. The parameters examined were the ease of laparoscopy, patient tolerance, the amnesic effect and intra-operative blood pressure changes. Depth of sedation and recovery time were measured, using the Trieger test. The preoperative demographic variables and the operators ability to perform the procedures were similar in the two groups. The patients were more deeply sedated with the midazolam but the recovery time was similar. The patients tolerated the procedure better with midazolam with fewer of them describing the procedure as unpleasant (22 percent versus 53 percent) (P<0.01), fewer of them had whole body movement during th procedure (24.5 versus 54.5 percent) (P=0.009) and more of them had amnesia for the procedure (85 percent versus 36 percent) (P<0.0001). However mean blood pressure rose to hypertensive levels intra-operatively in the midazolam group but not in the diazepam group.(AU)