Midazolam and diazepam in ketamine anaesthesia

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Ketamine is commonly used for short procedures.
• Adjuncts are often administered to improve anesthetic quality and patient experience.
• Midazolam and diazepam are benzodiazepines with sedative and anxiolytic properties.

Purpose of the Study:

• To compare the efficacy and patient acceptance of midazolam versus diazepam as intravenous adjuncts to ketamine anesthesia.
• To assess the incidence of induction and emergence sequelae, specifically unpleasant dreams, associated with each agent.

Main Methods:

• A comparative study involving healthy patients undergoing minor gynecological operations (<15 minutes duration).
• Intravenous administration of midazolam (0.07 mg/kg) or diazepam (0.12 mg/kg) as an adjunct to ketamine anesthesia.
• Patient-reported outcomes, including sequelae and acceptance, were collected via questionnaire.

Main Results:

• The incidence of unpleasant dreams was significantly lower with midazolam (6.7%) compared to diazepam (26.7%).
• No significant differences were observed in other induction or emergence sequelae between the two groups.
• Overall patient acceptance of the anesthetic technique was high, with 96.7% reporting positive experiences.

Conclusions:

• Midazolam is a preferable adjuvant to ketamine anesthesia over diazepam for minor gynecological procedures due to a lower incidence of unpleasant dreams.
• Both midazolam and diazepam demonstrate high patient acceptance when used as adjuncts to ketamine anesthesia.
• Further research may explore optimal dosing and patient selection for these anesthetic adjuncts.