Low-dose midazolam infusion for oculoplastic surgery under local anesthesia

Area of Science:

• Ophthalmology
• Anesthesiology
• Pharmacology

Background:

• Oculoplastic surgery is efficient and cost-effective under local anesthesia as a day-case procedure.
• Patients with fear or apprehension may benefit from per-operative conscious sedation.
• Midazolam, a water-soluble benzodiazepine, is a potential agent for conscious sedation.

Purpose of the Study:

• To evaluate the efficacy and safety of low-dose intravenous midazolam infusion for conscious sedation during oculoplastic surgery.
• To assess midazolam's impact on patient anxiety, pain perception, amnesia, and psychomotor recovery.

Main Methods:

• A controlled clinical trial was conducted with 48 subjects undergoing oculoplastic surgery.
• Participants received either a low-dose intravenous infusion of midazolam or a saline placebo.
• Pre- and post-operative questionnaires assessed anxiety, pain, amnesia, and psychomotor recovery.

Main Results:

• No adverse cardiorespiratory reactions were observed with midazolam infusion.
• Midazolam recipients reported significantly less intraoperative recall (p = 0.04).
• Patients receiving midazolam showed significantly reduced state-anxiety post-operatively (p < 0.02), unlike the placebo group.
• No significant difference in psychomotor performance was noted between groups 2 hours after surgery.

Conclusions:

• Low-dose continuous midazolam infusion provides safe and effective anxiolysis and conscious sedation.
• This method is suitable for oculoplastic procedures in a day-case setting.
• Good psychomotor recovery is achieved with this sedation approach.