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Int. J. Clin. Pract. · Nov 2021
Immediate retrograde amnesia induced by midazolam: a prospective, nonrandomized cohort study.
- Hye-Min Sohn, Hyo-Seok Na, Dongsik Lim, In Koung Yi, Sun-Woo Nam, Sang-Hwan Do, and Jung-Won Hwang.
- Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Gyeonggi-do, Republic of Korea.
- Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14402.
BackgroundMidazolam, a short-acting benzodiazepine, has sedative, anxiolytic, amnestic and anticonvulsant effects. Given its advantages of rapid onset, short duration and low toxicity, midazolam is optimal for any procedural sedation. Midazolam is known to cause anterograde amnesia; however, the possibility of retrograde amnesia has also been raised. This prospective cohort, non-randomised study evaluated the presence and extent of retrograde amnesia induced by midazolam during caesarean delivery.MethodsOne hundred parturients scheduled for elective caesarean delivery under spinal anaesthesia were enrolled. As soon as giving birth, six picture cards were shown to the patients in 1-min intervals, and then midazolam (0.1 mg/kg) was given or not according to the patients' preference. This overall retrograde recall rate of six cards was the primary outcome of our study, which was asked by a blinded investigator.ResultsThe overall retrograde card recall rate was lower in the midazolam group compared with the control group (77.0 ± 13.4 vs. 87.7 ± 3.9%, P < .001), especially at 1 minute before midazolam administration (58% vs. 88%, P < .001). Decreased memory trend was observed as time progressed towards midazolam administration in the midazolam group (P = .035). More patients answered 'yes' to the factitious event in the midazolam group than in the control group (26% vs. 4%, P = .004).ConclusionIntravenous midazolam could cause a brief-period retrograde amnesia in visual and event memory. Moreover, there were more spurious reports of intraoperative factitious events in the midazolam group, implying that episodic memories were also affected by midazolam.© 2021 John Wiley & Sons Ltd.
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