Sedation during spinal anaesthesia: comparison of propofol and midazolam

Propofol and midazolam were compared in 40 patients undergoing orthopaedic surgery under spinal anaesthesia. An infusion of either 1% propofol or 0.1% midazolam was given at a rate adjusted to maintain a similar level of sedation. The mean time to reach this required level was similar in both groups. Quality and ease of control of sedation were good in all patients. A mean infusion rate of 3.63 mg kg-1 h-1 was required for propofol and 0.26 mg kg-1 h-1 for midazolam. Immediate recovery, as judged by ability to open eyes and recall date of birth, was significantly more rapid following propofol (P less than 0.001). Similarly, restoration of higher mental function was significantly faster following propofol, measured by choice reaction time and critical flicker fusion threshold. Amnesia for the immediate postoperative period was significantly greater after midazolam (P = 0.0001).