• J Weindler, S Lieblang, G Mohamed, K Hille, and K W Ruprecht.
• Augenklinik und Poliklinik, Universität des Saarlandes, Homburg/Saar.
• Ophthalmologe. 1996 Feb 1;93(1):59-67.

AbstractRecent changes in the medical system have resulted in a significant increase in the number of surgical procedures performed as day surgery. Therefore, a safe and short postoperative recovery period has become increasingly important. In the present study we investigated perioperative cognitive and physiological functions after oral premedication with low-dose midazolam (3.75 mg). The study was carried out on at total of 55 women (age > 60 years, weight 50-90 kg) scheduled for elective cataract surgery under retrobulbar anaesthesia (RBA), who were randomly assigned to either group 1 (n = 35) receiving 3.75 mg midazolam p.o. or group 2 (n = 20) receiving placebo p.o. 30 min prior to RBA. We measured the following parameters: sedation (modified Glasgow Coma Scale); anxiety (visual analogue scale); numerical and verbal memory (digit span and reproduction of previously presented words); concentration (revision test of Stender/Marschner). To identify depression of ventilation, pulse oximetric oxygenation and end-tidal PCO2 (nasal) were monitored intraoperatively. In the midazolam group anxiety was significantly lower and patients were significantly more sedated than in group 2. At a check 30 min after premedication with midazolam the scores for concentration and numerical memory were significantly (P < 0.05) lower. No differences between the groups could be found 2 h after the operations (2.92 +/- 35 min after premedication). Intraoperatively there was no significant difference in end-tital PCO2 and oxygenation between the groups. Oral administration of low-dose midazolam (3.75 mg) seems to be an appropriate form of premedication for ambulatory surgical procedures in elderly patients.

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