Shirdashtzadeh Nasrin, Eshraghi Nazanin, Eshraghi Azadeh
Department of Anaesthesiology, Najaf Abad University of Medical Sciences, Isfahan, Iran.
Caspian J Intern Med. 2011 Summer;2(3):270-3.
Postoperative nausea and vomiting is a high unpleasant symptom in surgical procedures. This study compares the effectiveness of midazolam with promethazine as multipurpose drug in postoperative nausea and vomiting as a preoperative and anesthetic medication after appendectomy. Methods : This randomized, double - blind clinical trial study was performed in patients who underwent appendectomy. These patients randomly received either placebo or midazolam or promethazine 5 minutes before appendectomy. All episodes of vomiting and nausea within 24 hours after surgery were recorded. The study population (N=75) comprised 3 comparable subgroups (N=25 in each group). A standard general anesthetic technique and postoperative analgesia were used. The data were collected and analyzed.
Vomiting and nausea occurred in 19.20%, 0% and 81.80% of the patients in the midazolam, promethazine and placebo groups, respectively. The frequency of postoperative nausea and vomiting was as follows: the first 6 hours after surgery 0%, 0% and 50%, during the second 6 hours after surgery 19%, 0% and 19%, during the third 6 hours after surgery 0%, 0% and 7%, during the fourth 6 hours after surgery 0%, 0% and 4% in the midazolam, promethazine and placebo groups, respectively. There were no significant differences between promethazine with midazolam in reduction of postoperative nausea and vomiting.
Our study suggests that midazolam can be used as multipurpose drugs in postoperative nausea and vomiting as a preoperative medication after appendectomy and treatment using midazolam for anti-emetic, prophylaxis provide a similar effect compared to promethazine in the present study.
术后恶心呕吐是外科手术中一种非常令人不适的症状。本研究比较了咪达唑仑与异丙嗪作为多用途药物在阑尾切除术后作为术前和麻醉用药时预防术后恶心呕吐的效果。方法：本随机、双盲临床试验研究在接受阑尾切除术的患者中进行。这些患者在阑尾切除术前5分钟随机接受安慰剂、咪达唑仑或异丙嗪。记录术后24小时内所有的呕吐和恶心发作情况。研究人群（N = 75）包括3个可比亚组（每组N = 25）。采用标准的全身麻醉技术和术后镇痛。收集并分析数据。
咪达唑仑组、异丙嗪组和安慰剂组患者的呕吐发生率分别为19.20%、0%和81.80%。术后恶心呕吐的发生率如下：术后前6小时，咪达唑仑组、异丙嗪组和安慰剂组分别为0%、0%和50%；术后第二个6小时，分别为19%、0%和19%；术后第三个6小时，分别为0%、0%和7%；术后第四个6小时，分别为0%、0%和4%。异丙嗪和咪达唑仑在减少术后恶心呕吐方面无显著差异。
我们的研究表明，咪达唑仑可作为阑尾切除术后预防术后恶心呕吐的术前用药，作为多用途药物，在本研究中，使用咪达唑仑进行止吐预防与异丙嗪效果相似。
