Estudio randomizado, controlado sobre la efectividad de midazolam intraarticular versus midazolam i.v. en dolor después de artroscopía
A randomized controlled trial for the effectiveness of intraarticular versus intravenous midazolam on pain after knee arthroscopy.
Sajedi P, Nemati M, Mosavi SH, Honarmand A, Safavi MR.
J Res Med Sci. 2014 May;19(5):439-44.
Abstract
BACKGROUND: This double-blinded, randomized clinical trial was designed to evaluate the comparison of intravenous versus intraarticular (IA) administration of midazolam on postoperative pain after knee arthroscopy. MATERIALS AND METHODS: In this study, 75 patients randomized in three groups to receive 75 mc/kg IA injection of midazolam and 10 ml intravenous injection of isotonic saline (Group I), 75 mc/kg intravenous injection of midazolam and 10 cc IA injection of isotonic saline (Group II) or IA and intravenous injection of isotonic saline (Group III) at the end of knee arthroscopy. Pain scores, time until the first request for analgesics, cumulative analgesic consumption, satisfaction, sedation, and complications as studied outcomes were assessed. Patients were observed for 24-h. RESULTS: IA administration of midazolam significantly reduced pain scores in the early postoperative period compared with intravenous injection. Mean of time to first analgesic requirement in Group III (33.6 min) was significantly lower than Group II (288.8 min) and Group I (427.5 min). Cumulative analgesic consumption was increased in Groups II (35.5 mg), and III (70 mg) compared with Group I (16 mg), (P < 0.0001). Complications significantly occurred in 3 of 25 patients in Group I in contrast to 20 of 25 patients in Group III (P < 0.0001). At 2-, 4- and 8-h after arthroscopy pain score significantly decreased in Group I than other groups (P < 0.0001). Patients in Group I were significantly satisfy than other groups (P < 0.0001). CONCLUSION: Results show the greater analgesic effect after IA administration of midazolam than after intravenous injection and hence, IA administration may be is the method of choice for pain relief after knee arthroscopy.
KEYWORDS: Intraarticular administration; knee arthroscopy; midazolam; postoperative pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116576/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116576/?report=classic
Estudio de rango de dosis de midazolam intraarticular para el alivio del dolor después de la artroscopia de rodilla
A dose-ranging study of intraarticular midazolam for pain relief after knee arthroscopy.
Batra YK, Mahajan R, Kumar S, Rajeev S, Singh Dhillon M.
Anesth Analg. 2008 Aug;107(2):669-72. doi: 10.1213/ane.0b013e3181770f95.
Abstract
BACKGROUND:A variety of analgesic techniques have been used to manage postoperative pain after arthroscopic knee surgery. Intraarticularmidazolam may have an analgesic effect similar to that seen when midazolam is used in a centroneuraxial fashion. METHODS: Sixty ASA status I or II patients undergoing knee arthroscopy with general anesthesia were randomized to receive intraarticularmidazolam 50 mug/kg, 75 mug/kg, or isotonic saline. We assessed the efficacy of the analgesic technique with visual analog scale pain scores, time until first request for analgesics, and cumulative analgesic consumption. Patients were observed for 48 h. RESULTS:The addition of intraarticular midazolam significantly reduced visual analog pain scores in the early postoperative period compared with saline. Both doses similarly prolonged duration until first request for analgesic compared with saline (4.7 and 4.6 vs 0.7 h). There was no statistically significant difference between the two doses of midazolam or cumulative 48 h analgesic consumption. CONCLUSIONS: We conclude that when intraarticular midazolam was compared with placebo there was a reduction in pain after day-case arthroscopic knee surgery; however, this pain relief was of relatively short duration.
http://journals.lww.com/anesthesia-analgesia/pages/articleviewer.aspx?year=2008&issue=08000&article=00047&type=abstract
Efecto analgésico de midazolam cuando se agrega a lidocaína i.v. para anestesia regional intravenosa
The analgesic effect of midazolam when added to lidocaine for intravenous regional anaesthesia.
Kashefi P, Montazeri K, Honarmand A, Safavi M, Hosseini HM.
J Res Med Sci. 2011 Sep;16(9):1139-48.
Abstract
BACKGROUND:Midazolam has analgesic properties. The aim of the present study was to assess the analgesic effect of midazolam when added tolidocaine in intravenous regional anesthesia (IVRA). METHODS: Sixty patients undergoing hand surgery were randomly allocated into two groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the control group (group lidocaine saline ~ LS, n=30) or 50 μg/kg midazolam plus 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the midazolam group (group lidocaine midazolam ~ LM, n=30). Before and after the tourniquet application, hemodynamic variables, tourniquet pain, sedation, and analgesic use were recorded.RESULTS:
Shortened sensory and motor block onset time [4.20 (0.84) vs. 5.94 (0.83) min, p = 0.001 and 6.99 (0.72) vs. 9.07 (0.99) min, p = 0.001 in LM and LS groups, respectively], prolonged sensory and motor block recovery times [8.41 (0.94) vs. 5.68 (0.90) min, p = 0.001 and 11.85 (1.18) vs. 7.06 (0.82) min, p = 0.001 in LM and LS groups, respectively], shortened visual analog scale (VAS) scores of tourniquet pain (p < 0.05), and improved quality of anesthesia were found in group LM (p < 0.05). VAS scores were lower in group LM in the postoperative period (p = 0.001). Postoperativeanalgesic requirements were significantly smaller in group LM (p = 0.001). CONCLUSIONS: The addition of 50 μg/kg midazolam to lidocaine for IVRA shortens the onset of sensory and motor block, and improves quality of anesthesia and perioperative analgesia without causing side effects.
KEYWORDS: Anaesthetic Techniques; Analgesics; IV Regional Lidocaine; Midazolam; Postoperative; Tourniquet Pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430038/
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
A randomized controlled trial for the effectiveness of intraarticular versus intravenous midazolam on pain after knee arthroscopy.
Sajedi P, Nemati M, Mosavi SH, Honarmand A, Safavi MR.
J Res Med Sci. 2014 May;19(5):439-44.
Abstract
BACKGROUND: This double-blinded, randomized clinical trial was designed to evaluate the comparison of intravenous versus intraarticular (IA) administration of midazolam on postoperative pain after knee arthroscopy. MATERIALS AND METHODS: In this study, 75 patients randomized in three groups to receive 75 mc/kg IA injection of midazolam and 10 ml intravenous injection of isotonic saline (Group I), 75 mc/kg intravenous injection of midazolam and 10 cc IA injection of isotonic saline (Group II) or IA and intravenous injection of isotonic saline (Group III) at the end of knee arthroscopy. Pain scores, time until the first request for analgesics, cumulative analgesic consumption, satisfaction, sedation, and complications as studied outcomes were assessed. Patients were observed for 24-h. RESULTS: IA administration of midazolam significantly reduced pain scores in the early postoperative period compared with intravenous injection. Mean of time to first analgesic requirement in Group III (33.6 min) was significantly lower than Group II (288.8 min) and Group I (427.5 min). Cumulative analgesic consumption was increased in Groups II (35.5 mg), and III (70 mg) compared with Group I (16 mg), (P < 0.0001). Complications significantly occurred in 3 of 25 patients in Group I in contrast to 20 of 25 patients in Group III (P < 0.0001). At 2-, 4- and 8-h after arthroscopy pain score significantly decreased in Group I than other groups (P < 0.0001). Patients in Group I were significantly satisfy than other groups (P < 0.0001). CONCLUSION: Results show the greater analgesic effect after IA administration of midazolam than after intravenous injection and hence, IA administration may be is the method of choice for pain relief after knee arthroscopy.
KEYWORDS: Intraarticular administration; knee arthroscopy; midazolam; postoperative pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116576/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116576/?report=classic
Estudio de rango de dosis de midazolam intraarticular para el alivio del dolor después de la artroscopia de rodilla
A dose-ranging study of intraarticular midazolam for pain relief after knee arthroscopy.
Batra YK, Mahajan R, Kumar S, Rajeev S, Singh Dhillon M.
Anesth Analg. 2008 Aug;107(2):669-72. doi: 10.1213/ane.0b013e3181770f95.
Abstract
BACKGROUND:A variety of analgesic techniques have been used to manage postoperative pain after arthroscopic knee surgery. Intraarticularmidazolam may have an analgesic effect similar to that seen when midazolam is used in a centroneuraxial fashion. METHODS: Sixty ASA status I or II patients undergoing knee arthroscopy with general anesthesia were randomized to receive intraarticularmidazolam 50 mug/kg, 75 mug/kg, or isotonic saline. We assessed the efficacy of the analgesic technique with visual analog scale pain scores, time until first request for analgesics, and cumulative analgesic consumption. Patients were observed for 48 h. RESULTS:The addition of intraarticular midazolam significantly reduced visual analog pain scores in the early postoperative period compared with saline. Both doses similarly prolonged duration until first request for analgesic compared with saline (4.7 and 4.6 vs 0.7 h). There was no statistically significant difference between the two doses of midazolam or cumulative 48 h analgesic consumption. CONCLUSIONS: We conclude that when intraarticular midazolam was compared with placebo there was a reduction in pain after day-case arthroscopic knee surgery; however, this pain relief was of relatively short duration.
http://journals.lww.com/anesthesia-analgesia/pages/articleviewer.aspx?year=2008&issue=08000&article=00047&type=abstract
Efecto analgésico de midazolam cuando se agrega a lidocaína i.v. para anestesia regional intravenosa
The analgesic effect of midazolam when added to lidocaine for intravenous regional anaesthesia.
Kashefi P, Montazeri K, Honarmand A, Safavi M, Hosseini HM.
J Res Med Sci. 2011 Sep;16(9):1139-48.
Abstract
BACKGROUND:Midazolam has analgesic properties. The aim of the present study was to assess the analgesic effect of midazolam when added tolidocaine in intravenous regional anesthesia (IVRA). METHODS: Sixty patients undergoing hand surgery were randomly allocated into two groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the control group (group lidocaine saline ~ LS, n=30) or 50 μg/kg midazolam plus 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the midazolam group (group lidocaine midazolam ~ LM, n=30). Before and after the tourniquet application, hemodynamic variables, tourniquet pain, sedation, and analgesic use were recorded.RESULTS:
Shortened sensory and motor block onset time [4.20 (0.84) vs. 5.94 (0.83) min, p = 0.001 and 6.99 (0.72) vs. 9.07 (0.99) min, p = 0.001 in LM and LS groups, respectively], prolonged sensory and motor block recovery times [8.41 (0.94) vs. 5.68 (0.90) min, p = 0.001 and 11.85 (1.18) vs. 7.06 (0.82) min, p = 0.001 in LM and LS groups, respectively], shortened visual analog scale (VAS) scores of tourniquet pain (p < 0.05), and improved quality of anesthesia were found in group LM (p < 0.05). VAS scores were lower in group LM in the postoperative period (p = 0.001). Postoperativeanalgesic requirements were significantly smaller in group LM (p = 0.001). CONCLUSIONS: The addition of 50 μg/kg midazolam to lidocaine for IVRA shortens the onset of sensory and motor block, and improves quality of anesthesia and perioperative analgesia without causing side effects.
KEYWORDS: Anaesthetic Techniques; Analgesics; IV Regional Lidocaine; Midazolam; Postoperative; Tourniquet Pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430038/
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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