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

In a randomized study of 100 women (ASA 1-2) undergoing termination of pregnancy as outpatients, the combination of midazolam-fentanyl-nitrous oxide was compared with thiopentone-fentanyl-nitrous oxide. The induction time (the time recorded until disappearance of the palpebral reflex) was significantly longer in the midazolam group (40 s) than in the thiopentone group (31 s). There were no significant differences in heart rate or arterial pressure between the two groups. Thirty minutes after the termination of surgery the degree of awareness, estimated by means of Glasgow Coma Scale, was lower in the midazolam group. After 60 and 180 min the scores were equal. During recovery more patients experienced side-effects in the thiopentone group than in the midazolam group, the difference being statistically significant 72 h after discharge when 66% and 34% of the patients complained of side-effects, respectively. Midazolam is as suitable as thiopentone for the induction of anaesthesia in day-case surgery.