MIDAZOLAM PREMEDICATION INCREASES SEDATION BUT DOES NOT PROLONG DISCHARGE TIMES AFTER BRIEF OUTPATIENT GENERAL-ANESTHESIA FOR LAPAROSCOPIC TUBAL-STERILIZATION

Preoperatively administered midazolam may contribute to postoperative sedation and delayed recovery from brief outpatient general anesthesia , particularly in patients who receive significant postoperative opioi d analgesics. We evaluated the effects of midazolam premedication (0.0 4 mg/kg) on postoperative sedation and recovery times after laparoscop ic tubal sterilization (Falope rings) in 30 healthy women in a randomi zed, double-blind, placebo-controlled study. Patients received midazol am or saline-placebo intravenously 10 min before anesthesia. General a nesthesia was induced with fentanyl, propofol, and mivacurium and was maintained with N2O and isoflurane. Sedation was quantified before and after premedication and 15, 30, and 60 min after emergence from anest hesia, using the digit-symbol substitution (DSST) and Trieger dot (TDT ) tests. Management of postoperative pain and nausea and discharge cri teria were standardized. Groups were similar with respect to age, weig ht, and duration of surgery and anesthesia. Midazolam was associated w ith impairment of performance on the TDT and DSST after premedication administration and 15 (TDT and DSST) and 30 (DSST) min after postanest hesia care unit (PACU) arrival. There were no differences in PACU time and time to discharge-readiness. In conclusion midazolam premedicatio n augments postoperative sedation in this population but does not prol ong recovery times.