Postoperative effects of preoperative midazolam application in outpatient elective urological surgery

Objective: Preoperative medication, involves the psychological and a pharmaceutical preparation of patients to surgical procedures. The postoperative effects of preoperative midazolam application were evaluated in this prospective, randomized, double-blind study in urologic day case surgery. Methods: Sixty-four ASA I-II group male patients aged between 18-65 years undergoing daily urological surgery (varicocele, testicular sperm extraction, hydrocele) were included in the study. STAI test was performed in all patients before they brought to the operating room. Twenty minutes before the intervention, an anesthesiologist not included in the study administered 0.03 mg/kg midazolam to Group I, and saline solution to Group 2. During the postoperative period vital signs, the degree of sedation (Ramsay Sedation Score), postoperative pain scores (VAS 0-10), side effects (nausea, vomiting) of the patients were recorded. Home readiness criteria (PADSS ≥9) of the patients were also recorded. Between 4-6 hours postoperatively, STAI test was performed again on all patients. Results: Groups were comparable with respect to demographic data and duration of surgery. Preoperative STAI values, postoperative Ramsay Sedation Scores were similar in both groups. Although postoperative STAI values were lower in Group 1, the difference did not reach statistical significance. Time for home readiness was shorte in Group I. Postoperative pain scores in Group II were significantly higher than Group I. Conclusions: We concluded that in patients who underwent day case urologic interventions administration of 0.03 mg/kg iv midazolam can decrease pain scores without adversely effecting early postoperative recovery, and sedation scores, and shorten the time interval to home readiness criteria which may provide advantage in patients undergoing daily urological surgery.