Comparison between midazolam and thiopentone-based balanced anaesthesia for day-case surgery

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Outpatient anesthesia for pregnancy termination requires careful drug selection.
• Comparing induction agents is crucial for patient safety and recovery.

Purpose of the Study:

• To compare the efficacy and safety of midazolam-fentanyl-nitrous oxide versus thiopentone-fentanyl-nitrous oxide for outpatient pregnancy termination.
• To evaluate induction time, hemodynamic stability, recovery of consciousness, and post-operative side effects.

Main Methods:

• Randomized study involving 100 women (ASA 1-2) undergoing outpatient pregnancy termination.
• Comparison of midazolam-fentanyl-nitrous oxide with thiopentone-fentanyl-nitrous oxide anesthesia.
• Assessment of induction time, heart rate, arterial pressure, Glasgow Coma Scale, and side effects.

Main Results:

• Induction time was significantly longer with midazolam (40 s) compared to thiopentone (31 s).
• No significant differences in heart rate or arterial pressure were observed between groups.
• Lower initial awareness (Glasgow Coma Scale) in the midazolam group, with scores equalizing by 60-180 minutes.
• Significantly fewer side effects reported in the midazolam group 72 hours post-discharge (34% vs. 66%).

Conclusions:

• Midazolam is a suitable alternative to thiopentone for induction of anesthesia in day-case pregnancy termination surgery.
• Midazolam offers a potential advantage in reduced post-operative side effects compared to thiopentone.